April 18, 2024

Solve the organ shortage with euthanasia, says leading bioethicist

Oxford don Julian Savulescu thinks that doctors should kill consenting brain-dead patients for their organs.

It was only a matter of time before someone
would construct a serious formal argument for solving the growing organ
shortage by euthanasing brain-dead or unconscious. It has finally happened. The
only surprise is that it has been made by an Oxford don who is on the editorial board of a leading journal, Bioethics.*

Professor Julian Savulescu and his
associate Dominic Wilkinson, in an early on-line article, “Should
we allow organ donation euthanasia? Alternatives for maximizing the number and
quality of organs for transplantation”,
contend that their proposal could
supply as many as 2,200 more organs each year in the UK.

Savulescu and Wilkinson’s idea runs like
this. It is indecent that 450 people die in Britain while waiting for an organ.
People who are on life support or who are brain-dead are potentially a good
source of organs, as each body can yield as many as nine of them. Organs taken
from living patients are most suitable for transplant, because every second
after the heart stops beating decreases the chances of transplant success. Patients
would, of course, have to assent to the procedure before they became
unconscious. And they envisage taking organs only from patients who would die
soon anyway.

Adopting their proposal would be a
revolution in medical ethics, they acknowledge, as doctors have always been
forbidden to kill patients. And they also realise that the public would be
unlikely to embrace the idea. “But if we can save even one life, that is
something of great moral importance,” they write. “Many lives could be saved
even if only a small percentage of people opted for [organ donation

Their principal concern is to solve the
organ shortage, but this idea also provides a strong argument for euthanasia: “although
most arguments for euthanasia are distinguished from questions of organ donation,
it may be that the benefits of donation, for the individual and for others,
provide the strongest case for euthanasia.”

Savulescu and Wilkinson restrict their
argument to patients who are on the verge of death in an intensive
care ward. But organs taken from patients in a permanent vegetative state would
be just as, if not more, useful. And, in fact, they argued
this a couple of years ago

“But there is another more radical way to
increase the supply of organs. We could abandon the dead donor rule. We could
for example, allow organs to be taken from people who are not brain dead, but
who have suffered such severe injury that they would be permanently
unconscious, like Terry Schiavo, who would be allowed to die anyway by removal
of their medical treatment.”

* An earlier version of this misstated Professor Savulescu’s relationship to the journal Bioethics. He is a member of its editorial board. 

Michael Cook
Julian Savulescu
organ donation