March 24, 2023

New frontiers in organ donation: from DDR to ODE to LVOD

After Organ Donor Euthanasia (ODE), what’s next? Living vital organ donation (LVOD) – giving your heart away even though you aren’t ill or dying. Apologies to readers for having missed this fascinating article in the leading journal Bioethics, but it retains its relevance.

Organ donor euthanasia is already radical, because it violates the dead donor rule (DDR). This states that vital organs can only be removed from donors who are truly dead (what that means is another controversy). Danish bioethicist Didde B. Andersen argues that ODE is too conservative.

While I am sympathetic to this proposal I do not think it goes far enough. In this paper, I show that the key reasons put forward in favor of permitting ODE actually justify a more far-reaching suggestion for regulation, permitting people to become living vital organ donors even when they are not about to die for other reasons.

She appeals to the values of autonomy and beneficence.

What about people who face a few years of declining health? Instead of being miserable, they could help someone live a healthy life. What about people who have attained a “completed life”? They could exit while helping someone. Of course, it would be necessary for these irreversible decisions to be fully autonomous. “We should have procedures that safeguard against … pressures,” she writes, “ensuring that people are aware that they have the right to be treated and are not expected to sacrifice themselves for others.”

Andersen concludes that “only accepting imminently dying people as eligible donors for living vital organ donation would be objectionably paternalistic.”