‘Death by Organ Donation’ Pushed in Prestigious Medical Journals

Commentary

The late Fr. Richard John Neuhaus famously wrote that bioethicists “professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable until it is finally established as the unexceptional.”

He was right. Radical bioethical policies don’t just appear like magic out of the ether. Controversial—even pernicious—ideas are often debated in bioethics and medical journals where few among the public ever see them. Then, if a general consensus is reached within the field, policies once considered “unthinkable” are “suddenly” elevated into the justifiable and become unexceptional public policy.

Here are just two examples. Legalizing assisted suicide was once way beyond the pale. Then, bioethicists began arguing in favor of such laws, after which hastened death became debatable, then justifiable, and now, in many jurisdictions, so unremarkable that many thousands of people have died by that method.

Similarly, starting about 2009, articles in professional journals began arguing that gender dysphoric children should be “treated” with puberty blockers. Just a little more than a decade later, puberty blocker transitioning was deemed so justifiable by the Biden administration that it became official government policy, as several blue states enacted laws that authorize removal of custody from parents who refuse to go along.

That is why notice must be taken of the ongoing attack in bioethics discourse on the organ donation “dead donor rule” (DDR). The DDR requires that vital organ donors be truly dead before their body parts are procured. A corollary holds that people cannot be killed for their organs.

Alas, repealing the DDR is now at the “debatable” stage of bioethical discourse. This is potentially catastrophic. If people believe that they or their loved ones are in danger of having their organs taken while alive should they become seriously ill or injured—or even worse, be killed for their body parts—faith in the system could collapse like a poorly constructed building in a 7.5 Richter scale earthquake.

But don’t tell that to too many bioethicists. In the current issue of the influential Journal of Medical Ethics, a bioethics professor argues that the DDR is inconsistent with less controversial bioethical policies.

For example, the professor claims that since the altruistic donation of one kidney harms a living patient through reduced kidney function without violating the DDR, it is also okay to take the liver of living donors.

Donating a kidney rarely leads to the death of a donor, and if the worst happens, it is inadvertent. But if a liver were procured from a living person, they would be dead within hours, no exceptions. That’s a major distinction with a huge difference.

Similarly, the professor suggests that surgery to save a fetus harms the mother through incisions and the like, which she willingly accepts as less important than the well-being of her baby. He even goes so far as to claim that an emergency C-section that will likely lead to the mother’s death to save the baby is an example of harm caused by doctors that consistency requires should also permit the procurement of vital organs while the donor is still alive.

The first two may or may not lead to unintended death. The latter example definitely will.

Even more explicitly, an advocacy article published by the New England Journal of Medicine in July argued not only that euthanasia should be conjoined with organ harvesting—already being done in countries such as Canada, the Netherlands, and Belgium—but that to obtain better organs, where euthanasia is legal, the means of killing should be the organ harvest itself. The authors label this policy proposal: “death by organ donation.”

Death by organ donation would enable cardiac donation and improve recipient outcomes by reducing warm ischemia time, thereby lowering primary graft-dysfunction rates to levels similar to those achieved with donation after brain death. In addition, it might substantially increase the donor pool, potentially saving many lives.

How respectable have these and other kill-to-harvest proposals become?

It doesn’t get more prestigious than the NEJM or the Journal of Medical Ethics. Indeed, the idea of killing for organs has become sufficiently “debatable” in the mainstream that one of the death-by-organ-donation authors was featured in a respectable interview on NPR.

Putting the DDR in the bioethical crosshairs is both unwise and potentially harmful. The public’s trust in the sector is already only an inch deep.

Making confidence even more precarious, Health and Human Services Secretary Robert F. Kennedy Jr. made headlines recently when he withdrew the government’s certification from two organ procurement organizations—one in Florida and one in Kentucky—because of egregious ethical lapses, including the Kentucky organization pushing to continue an organ harvest even though the donor was still moving!

Thankfully, the doctors refused to carry out the surgery. No thanks to the procurement organization, that patient recovered and ultimately left the hospital.

At this point, it is important to note that death by organ donation remains controversial in bioethics discourse and continues to be illegal even where assisted suicide is allowed. But that status quo is not grounds for complacency. Maintaining morality in transplant medicine is too important to leave to bioethicists.

If we want to prevent organ donations from becoming ghoulish and maintain the public’s trust in the sector that saves so many lives, we must make it abundantly clear that this debate is going nowhere, that no one will ever be killed for their organs.

Then, and only then, will this pernicious proposal be returned to the “unthinkable” stage of bioethical thinking where it belongs.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.