December 9, 2021

‘A pure act of altruism’: organ donation after euthanasia

Dutch physicians argue for at-home euthanasia before retrieving organs

Organ donation after euthanasia is possible in the Netherlands, Belgium and Canada. However, it still is not a very popular option. It seems to have been performed only 70 times in the Netherlands. Most people prefer to be euthanised at home and by the time their body arrives at hospital, the organs are no longer in a state to be used.

However, several physicians and a bioethicist have published a paper in BMC Medical Ethics recording how they successfully managed to carry combine dying at home and organ donation. The man who was euthanised was the husband of one of the authors of the article.

Logistically, it is a bit tricky. The 63-year-old man, who was suffering from multiple system atrophy, was sedated at home surrounded by his family and then transported to a nearby hospital. There he was euthanised by his family doctor. The transplant specialists waited for the mandated 5 minutes and then extracted the organs. They were able to retrieve both kidneys, the liver and the pancreas.

Legally, the authors acknowledged that the procedure stretched the letter of the law. In the Netherlands, a patient must be suffering hopelessly and unbearably. However, after being sedated, he is no longer suffering. How can he consent to euthanasia? However, everyone involved agreed that the procedure honoured the spirit of the law.

Ethically, the authors ticked off all of the Belmont principles of autonomy, beneficence, non-maleficence, and justice. “From a utilitarian perspective,” they say, “the decision to honour the last wishes of the patient produced the greatest good for many other patients.”

They conclude that “From the patient’s perspective, falling asleep in the intimacy of his own home and with his loved ones present appears to be a good alternative to the medicalisation of organ donation after euthanasia in the hospital.”

“Organ donation after euthanasia,” they declare, “is a pure act of altruism.”