Does It Matter How We Die? Ethical and Legal Issues Raised by Combining Euthanasia and Organ Transplantation

Abstract

If, in jurisdictions with legalized euthanasia, obtaining organs for transplant from euthanized people is allowed, must their organs be taken only after death or should euthanasia be allowed to be performed by removal of vital organs? Asked another way, if “Donation after Death” is practiced, why not “Death by Donation?” The article addresses two questions. First, “What issues does connecting euthanasia and organ donation raise?” They include dealing with uncertainty regarding the definition of death, defining what constitutes conscientiously objecting healthcare professionals' involvement in euthanasia, and whether connecting euthanasia and transplantation makes conflicts of interest for healthcare professionals unavoidable. Additional issues raised by death by donation include breach of the “dead-donor rule”; what would constitute informed consent to it; and what impact its acceptance would have on important foundational societal values, especially respect for human dignity and human life. The second question is “Why might some people who agree with euthanasia and even organ donation after death by euthanasia find death by donation ethically unacceptable?” Considerations again include its harmful impact on upholding respect for human dignity and human life and that the “wisdom of repugnance” could be informing these people's reaction. It is concluded that in order to avoid serious breaches of ethics, organ transplantation and euthanasia should not be linked in any way.