Tuesday, May 11, 2010

We're Sliding Down A Slope

Oxford bioethicists Julian Savulescu - for whome virtually anything goes- writing with Dominic Wilkinson argues, that euthanasia coupled with organ harvesting, would be a splendid way to obtain more livers, kidneys and hearts. This article was published in Bioethics titled "Should We Allow Organ Donation Euthanasia?"
Wesley J Smith has a theory, "If you are a bioethicist - the more brutal your ideas, the more denigrating of human exceptionalism you become, the more crassly utilitarian direction in which your advocacy flows - the more prestigious the university that will give you a tenure chair and a big salary, and the more likely you are to get the big grants. "Think Peter Singer and personhood theory/infanticide/Great Ape Project in Princeton and, as here, Julian Savulescu and Oxford. "Interestingly, both are Australian, so perhaps a pleasing accent is part of the mix. "In any even the article only supports my theory, but proves another point I often make - if you want to see what is going to go wrong in society tomorrow, just read the professional journals' articles published today."
In the article, the authors say "If we believe that we should not remove organs from patients who are still alive, even where they have consented to this, and would otherwise die anyway, then one alternative would be to euthanize the donor and retrieve organs, after cardiac death had been declared. "This would already be a theoretical option in countries where euthanasia is permitted. Organ donation after cardiac euthanasia has been described in a patient in Belgium. Organ donors could be given large doses of sedative, and cardioplegic agents (to stop the heart). Again, this would reduce the risk of patient suffering after withdrawal of life sustaining treatment, and make organ donation possible for some patients, who would otherwise not be able to donate."
Wow! A slipper slope indeed. I wonder when it will come to the United States. After all, euthanasia is legal in 4 states.



Ori Pomerantz said...

I normally have a problem with euthanasia. But if I had to choose between what would likely be another hour of life for me, and years of living for 3-4 other people, I think I should die earlier so that others may live.

1. Is it licit for a person to agree to sacrifice his life so that others may live?

2. If #1 is licit, is it licit to commit in advance, that under certain circumstances you'll die so that others can live?

3. If #2 is licit, is it licit for somebody else to perform the action that actually gets you killed?

#1 and #2 have precedents in the military. Soldiers go to dangerous missions knowing they may die. Sometimes, they go to missions knowing they won't survive. They commit to doing this well in advance.

Paul, just this guy, you know? said...

Ori, I see two problems here:

First, it's not the job of doctors to kill. When it becomes so, I think we've got a major problem.

Second, you can't know you only have an hour to live. Doctors just don't know this.

Additionally, as we've already seen in places where euthanasia has become accepted, involuntary euthanasia always follows.

Ori Pomerantz said...

That's the reason I said "what would likely be another hour of life to me". A lot of medicine is about balancing tradeoff. In this case, it is about balancing shortening one life, and prolonging another. It's a hard choice, but deciding to do nothing when something is within your power is also a decision.

The slippery slope argument is harder to deal with. It might be better that a few sick people will die earlier than they would have otherwise, to avoid it. I'll need to think about it.

Berndog said...

The legal basis for withholding life sustaining care is the right of a person to decide what happens to their own body. Thus, treatment can be withdrawn if demanded by a a patient, but a patient cannot demand that they be killed.

Pomerantz argues that "it might be better that a few sick people will die" is cavalier. A "sick person" no matter how "sick," cannot be killed for their organs. They can only donate them after a clear and well documented declaration of death.

Bernard W. Freedman, JD, MPH

Ori Pomerantz said...

Brendog: Pomerantz argues that "it might be better that a few sick people will die" is cavalier. A "sick person" no matter how "sick," cannot be killed for their organs.

Ori: I'm sorry, I didn't explain myself correctly. The sick people I was referring to are the ones whose lives might be prolonged if my organs are donated at a point when I appear close to death to the doctors.

If the chance of me surviving is slim anyway, I believe I(1) should be willing to forgo that slim chance at life to save somebody else whose chances are much better.

Paul's point was that if this becomes common practice, then involuntary euthanasia would follow. To avoid it requires letting me keep the slim chance of survival in these circumstances, and not giving what would have been the organ recipients' much higher chance of life. That is the sacrifice I was talking about.

(1) Personal choice, not something mandated by the government.