Using organs from euthanased patients seem to have become a well established procedure in Belgium, only nine years after it was legalized. A press release from a team at a hospital in Leuven announced last week that it had successfully transplanted lungs from four euthanased patients between 2007 and 2009.
In an article in the journal Applied Cardiopulmonary Pathophysiology, the authors observe that the quality of the lungs from euthanased patients is superior to those obtained from brain dead donors and donations after cardiac death.
"In contrast to these donors, euthanasia donors do not experience an agonal phase before circulatory arrest as seen in donors dying from hypoxemia or from cardiogenic or hypovolemic shock."
A number of patients who request euthanasia want to donate their organs. However, since they often have cancer, the organs are not suitable. Three of the euthanased patients who did donate suffered from "a debilitating benign disease such as a neurological or muscular disorder". The other was not ill at all, but had an "unbearable mental disorder".
The authors were at pains to stress that they acted strictly within the guidelines for euthanasia in Belgium. All of the patients gave their consent.
Organ donation after euthanasia in Belgium is well organized. The ethics committee of Eurotransplant, a coordination network for transplants in Austria, Belgium, Croatia, Germany, Luxembourg, the Netherlands and Slovenia, has already developed elaborate protocols for "organ donation and transplantation after euthanasia". These include:
Although exploiting patients' wish to die for the sake of organ transplants may horrify many readers, this business has not been taking place in a dark basement. The Belgian team has not been shy about publicising their work. They described it at the 2006 World Transplant Congress and last December at a conference organised by the Belgian Royal Medical Academy. The journal article seems to be the first time, however, that information about their work is readily accessible. Criteria for accepting organs from patients were published in Eurotransplant's 2008 annual report.
A host of probing questions need to be asked. We only know about transplants from euthanased patients at one hospital in Belgium. But euthanasia is legal in the Netherlands and Luxembourg as well. At how many hospitals is this going on? It is illegal to tell recipients where their new organs came from. Wouldn't many recipients object to that?
A document on the Eurotransplant website, "Current ethical considerations in organ transplantation", fails to include transplants from euthanased patients amongst the ethical problems. Does that mean that it is not an ethical problem? Eurotransplant declares that "transparency" is a key corporate value. Yet its 2010 annual report omits the word "euthanasia".
Eurotransplant has condemned the Chinese practice of using organs from executed prisoners.
"The commercial exploitation of organs from executed prisoners is considered a breach of human rights and is an unacceptable practice... any act that risks calling the practice of transplantation into disrepute is to be regretted."
Doesn't using organs from a mentally ill person who thinks that life is not worth living call the practice of transplantation into disrepute as well?