February 24, 2024

Home is where the heart is for Dutch euthanasia

Doctors have developed home-based euthanasia plus organ donation

There’s always something new that you can learn about euthanasia practices. An indignant letter to JAMA Surgery by two surgeons from a hospital in the Netherlands led BioEdge back to a 2017 letter in Transplant International about home-based euthanasia + organ donation. It’s not one of  the better publicised features of Dutch euthanasia.

Apparently many people are interested in organ donation after euthanasia, but they would still prefer to die at home. This cuts off a useful source of organs. These resourceful doctors, Johan P. C. Sonneveld and Johannes Mulder, from Isala Hospital, developed domestic organ donation after euthanasia as a “newly introduced, donor-friendly donation procedure”. It even has its own acronym, DODE. 

The key point is “separating the experience of dying at home from subsequent biological death and organ donation in hospital using an anaesthesia bridge.” The patient is sedated and intubated at home where he lapses from consciousness surrounded by his family. Then he is taken, unconscious, to the hospital in an ambulance, euthanised, and operated on. 

Commencing the euthanasia procedure at home is much more humane, they argue. “Suggesting that euthanasia must take place in the hospital disregards the deepest wishes of these donors: sick, hospital-weary human beings who have decided to end their pain in the comfort and privacy of their own home,” write the doctors.

It’s not clear how often this happens – probably only in a handful of cases every year at the moment.    

Ah yes, why were they indignant? Because a 2020 article in JAMA Surgery had suggested that the best-practice location for organ donor euthanasia is the hospital. Not so, they say. “Advocating the necessity for a hospital stay will alienate many potential donors.”

Michael Cook is editor of BioEdge   

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