Doctors in the Netherlands are developing a protocol which will increase the number of organs from people who request euthanasia. Erasmus Medical Centre in Rotterdam and the University Hospital of Maastricht have written national guidelines which are being studied by the Dutch Transplant Foundation.
If the procedures are approved, they would be binding on hospitals and doctors throughout the country.
Spurring on this study is the feeling among transplant surgeons that healthy organs are sometimes wasted when patients are euthanased. In the words of a medical ethics expert with the Royal Dutch Medical Association, Gert van Dijk, “An estimated 5 to 10% of people who are euthanased could be considered for organ donation. Five percent does not seem like much, but this still means 250 to 500 potential organ donors every year.” He believes that Dutch doctors could even double the number of organs available for life-saving procedures. It could also give donors the consolation of knowing that they are saving lives even if they themselves have to die.
Up to now, there have only been six case of organ donation after euthanasia in the Netherlands. More have been done in neighbouring Belgium, where euthanasia is also legal.
While getting euthanasia patients to donate organs might sound easy, in practice there are a number of difficulties. Most euthanasia patients have cancer and so their organs are not suitable for donation. The most suitable patients are those with neurodegenerative diseases like ALS or multiple sclerosis.
There are administrative issues as well. Most hospitals are adverse to allowing doctors to perform euthanasia if they are not staff members. Many euthanasia patients want to die at home, but if they want to donate their organs, they have to die in an operating theatre, away from their loved ones.
The protocol will probably create some firm guidelines:
Procedures for euthanasia and organ donation must be completely separate. Only if a person fulfils all the criteria for euthanasia would he be eligible for organ donation.
The idea of donating organs must come from the patient, not the doctor.
Only a doctor who is not involved in the organ donation can confirm the patient’s eligibility for euthanasia.
The euthanasia doctor must sign a statement indemnifying the hospital against future lawsuits.
Michael Cook is the editor of BioEdge, from where this article is adapted.
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