Published June 14, 2011
Doctors are harvesting lungs from patients in Belgium who’ve been euthanized because the organs are in much better condition compared to someone who has died in an accident, according to a study published in the journal Applied Cardiopulmonary Pathophysiology.
The authors of the study, Initial Experience with Transplantation of Lungs Recovered From Donors, reported their experience with four recipients who received lungs between 2007 and 2009 from euthanized donors.
“Immediate graft function was excellent in all recipients and pulmonary function improved significantly early after transplant,” they said in the report.
So could this medical practice happen here in the U.S. someday?
Well, it’s not likely since euthanasia is not legal here in the United States, but one medical ethicist from Wake Forest University in North Carolina said it doesn’t seem that out of the ordinary in a country where this practice is legal.
“Insofar as euthanasia has been legalized in Belgium, it’s hard to see why they wouldn’t want to take organs for transplantation,” said Ana Iltis, director of the Center for Bioethics Health and Society at Wake Forest University in North Carolina. “People tend to respond with an ‘Ick,’ but that response should be about euthanasia. Once you accept that physicians are going to kill patients, it seems logical that they would harvest those organs for transplantation.”
Dr. Peter Saunders of the group, Care Not Killing, which is a U.K.-based alliance opposed to euthanasia, expressed to The Daily Telegraph that he is very concerned about what is unfolding in Belgium.
“Given that half of all euthanasia cases in Belgium are involuntary, it must be only a matter of time before the organs are taken from patients who are euthanized without their consent,” Saunders told The Telegraph. “The matter of fact way the retrieval process is described in the paper is particularly chilling and shows the degree of collaboration that is necessary between the euthanasia team and the transplant surgeons – prep them for theater next to the operating room, then kill them and wheel them in for organ retrieval. All in a day’s work in Brave New Belgium. Doctors there are now doing things that most doctors in other countries would find absolutely horrific.”
Iltis said a 2010 report by the Canadian Medical Association highlighted the fact that 66 out of 208 patients in Belgium were euthanized without explicit patient request – and that’s worrisome.
“You can imagine cases – maybe the patient’s family requested it – but the law as I understand it requires an explicit patient request,” she said.
For example, in Oregon, the first state to pass a “Death With Dignity Act,” there are very specific guidelines that must be followed.
The law states, “in order to participate, a patient must be 18 years of age or older, a resident of Oregon, capable of making and communicating health care decisions for him/herself, and diagnosed with a terminal illness that will lead to death within six months. It is up to the attending physician to determine whether these criteria have been met.”
And when it comes to a patient's family requesting to act on behalf of their loved one – that’s a no go.
“The law requires that the patient ask to participate voluntarily on his or her own behalf,” it is stated on the Oregon Health Authority website.
Iltis said we should take the Belgium experience “and learn from it.”
EUTHANASIA VS. PHYSICIAN-ASSISTED SUICIDE
Here in the U.S., some states like Oregon and Montana have legalized physician-assisted suicide, which is much different. The laws vary from state to state, but with physician-assisted suicide, the patient would receive a prescription from the doctor for some pills and kill themselves on their own time, Iltis said, whereas with euthanasia, the doctor or nurse can inject a lethal cocktail into a patient’s IV.
Iltis said a patient requesting physician-assisted suicide would be too sick to donate his or her organs, but in Belgium, a person doesn’t necessarily have to be sick to be euthanized.
“In one of the cases the person had a mental condition,” Iltis noted.
Euthanasia has been legal in Belgium since 2002, and the study’s lead author, Dr. Dirk van Raemdonck said all of the donors – who had suffered from an unbearable physical or mental disorder – had given their consent.
“All donors explicitly and voluntarily expressed their wish to become an organ donor once their request for euthanasia was granted,” the authors said in the report.
The study also revealed that Eurotransplant, a coordination group for transplant in several European countries, is now developing strict protocols for “organ donation and transplantation after euthanasia.”
Karlie Pouliot contributed to this article.