How do you convince society to embrace euthanasia as a means of attaining utilitarian benefit — while also convincing yourselves that your culture remains both moral and compassionate? Once you get past the squeamishness of allowing doctors to kill patients, it isn’t that difficult: First, legalize euthanasia of the seriously ill and disabled. Once the community becomes comfortable with doctors committing homicide as a means of eliminating suffering, you next allow those who want to be killed to donate their organs. After all, they won’t need their livers anymore, so why not let others have them? Next, ensure that the potential of euthanasia to add to the organ supply becomes well known, both to normalize doctor-administered death and to induce people to believe they or a loved one might personally benefit from doctors killing the sick. Finally, over time, you expand euthanasia/organ donation eligibility to patients who are far from death, such as those with neuromuscular disabilities or psychiatric illnesses — better organs, don’t you know — justifying it as you go along with soothing words of respecting autonomy and preventing suffering.
Lest any reader believe that I am conjuring a paranoid dystopian fantasy, this very scenario consumed the medical and organ transplant ethics of the Netherlands and Belgium, nations in which patients with mental illnesses and other diseases are admitted to hospitals, killed by lethal injection, and then wheeled immediately into a surgical suite for organ harvesting. When I bring up these facts in domestic debates about assisted suicide, supporters of doctor-prescribed death sniff that the Netherlands and Belgium are not the United States, and that such crass utilitarian exploitation of the despairing would never happen here. But why? Once we deem certain categories of people to be killable — which is precisely what legalizing assisted suicide and euthanasia does — it becomes all too easy to conclude, as Belgians and Netherlanders have, that since these patients want to die we might as well benefit societally from their deaths.
That is precisely what happened in Canada, the United States’ closest cultural cousin, and indeed, a country many Americans see as having more enlightened public policies than our own. In the three years since lethal injection euthanasia became legal in Canada, at least thirty people were organ harvested after being euthanized. That number may soon increase dramatically as the Canadian medical establishment has come out solidly in favor of letting people who die by euthanasia to also become organ donors.
A major ethics “Guidance” was just published in the Journal of the Canadian Medical Association that establishes euthanasia kill-and-harvest (my blunt term) protocols. It makes for a chilling read.
Read it all.