WASHINGTON A dangerous precedent was set in Belgium, an ethicist said, when a woman chose assisted suicide and then opted to donate her organs.
Wesley Smith, a bioethics fellow at the Discovery Institute, said agreeing to harvest organs from euthanasia "raises the very realistic prospect that despairing people with terminal illnesses or disabilities (or perhaps, just despair) could latch onto being killed for their organs as a way of bringing meaning to their lives."
"This very dangerous territory, made all the more treacherous by doctors, spouses and a respected medical journal validating the ideas that dead is better than disabled and that living patients can, essentially, be viewed as a natural resource to be killed and mined," Smith wrote on the Secondhand Smoke blog at FirstThings.com in May.
The woman in Belgium was not terminally ill, Smith said. She was fully conscious but completely paralyzed, a state he called "locked-in." She asked for her doctor's assistance in carrying out her desire to die, and the day before the euthanasia procedure, she decided to allow her organs to be transplanted.
In the presence of her husband, Smith recounted, the woman was killed intravenously and her body was moved to the operating table 10 minutes after cardiac activity had ceased. Her liver and both kidneys were removed, and a year later the three recipients have responded well.
"If this doesn't set off alarm bells about how the sick and disabled are increasingly being looked upon not only as burdens (to themselves, families, and society), but potential objects for exploitation, what will?" Smith wrote. "A disabled woman was killed, even though people with locked-in states often adjust over time to their disabilities and are happy to be alive."
The woman's story appeared in the bioethics journal Transplantation, perhaps authenticating the coupling of the two procedures in the minds of some.
"This case of two separate requests, first euthanasia and second, organ donation after death, demonstrates that organ harvesting after euthanasia may be considered and accepted from ethical, legal and practical viewpoints in countries where euthanasia is legally accepted," Smith wrote.
"This possibility may increase the number of transplantable organs and may also provide some comfort to the donor and his (her) family, considering that the termination of the patient's life may somehow help other human beings in need for organ transplantation.
"Taking the organs was the easy decision. Once you've pulled medicine into the forbidden zone of active killing, finding self-congratulatory justifications becomes a most desirable quest," Smith wrote, adding that "once society accepts that the two can be joined, saving others could easily become a frequent motivation for asking to be killed."
Also in May, articles in the Canadian Medical Association Journal said about one in 25 deaths in Belgium is by euthanasia, and of those, 2 percent take place after a direct request of a doctor; 1.8 percent occur without such a request.
Voluntary euthanasia must be performed by a physician in Belgium, but it is done 12 percent of the time illegally by nurses, the report said. In 2009, Belgium officially had 700 euthanasia deaths, a jump from 500 such cases in 2008, according to a March report by Flanders News. These are officially reported figures, and experts say they represent only 25 percent of the actual totals.