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Further push for killing for organs

This article came from Wesley J. Smith last September, but I'm just now getting around to highlighting it.

A fairly recent piece by a bioethicist named Zoe Fritz has argued yet again for killing for organs. Fritz is especially pushing it for people who would otherwise be dehydrated to death.

The active-passive distinction is very important in ethics, but when it comes to deliberately dehydrating someone to death for whose care you are responsible, then that is a form of murder just as much as a lethal injection. The answer, of course, is not to murder people at all. Fritz takes it in the opposite direction (it's almost impossible to do a reductio on the culture of death, because they will always embrace the reductio) and opts for active murder.

Her idea is a lethal injection to stop the heart, followed by taking organs. She appears unaware that stopping the heart isn't really what organ transplant teams most want, especially if it's going to be stopped for more than, say, five minutes. On the contrary, they want the heart to keep going as long as possible, especially if you're trying to get some vital organ other than kidneys, and especially if you're trying to get the heart itself. But I have little doubt that if she were brought up to speed by this pair of doctors she would be happy to opt instead for their idea: Just taking the patient off to surgery and killing him by removing his vital organs, which are nicely oxygenated right up until the last moment. (Presumably you take his heart last.)

Belgium is already combining euthanasia with organ harvesting. In the case reported they apparently used a lethal injection and allowed a no-heartbeat time of ten minutes and then took both kidneys and a liver. I'm surprised the liver was considered usable after that amount of time with no heartbeat. Kidneys are generally a little more tolerant of warm ischemia. The article doesn't say what procedures were taken to begin oxygenating the organs once the person's body was placed on the operating table for taking the organs.

What has to be said is this: Pro-life Americans ought to give up on vital organ harvesting after death. To some, it sounded like a good idea. Though frankly, I can't help wondering why it didn't sound more ghoulish than good, right from the beginning. But apparently some people find it an obvious win-win: This person who has died doesn't need his heart, liver, lungs, or kidneys anymore. Someone else can use them. Why not let them be used after his death?

But as I am always saying (read many articles at this label), you can't walk up to a stone-cold corpse and just remove a handy liver or heart and put it into someone else. It doesn't work that way. Instead, the donor usually has to be in a twilight zone with the organs being oxygenated by blood circulation as long as possible. So in practice, it was never so simple, never, as just taking organs from someone who was undeniably dead. There are more rigorous and less rigorous criteria for biological death, but the more rigorous you get, the fewer organs you get. To the point that it isn't clear at all that there is a way to be really sure that someone from whom usable organs are taken is dead-dead. This is especially true of a heart.

What Fritz's proposal and the Belgian practice shows us is one consequence of treating a dead human body as a source of supply, nothing more than a thing, and the near-death patient as a means to an end. Once you do that, it becomes increasingly irksome that people don't die in precisely the fashion needed to get their organs. Hence the (again) ghoulish phrase about x number of usable organs "buried" every year--by which the speaker always means that people's corpses are buried.

I will not say that it is logically required that one endorse bare-faced murder if one becomes a real enthusiast for vital organ donation. There are many well-intentioned and even pro-life people who are such enthusiasts. But I will say that unscrupulous bioethicists like Zoe Fritz will be only too happy to use that enthusiasm for their own ends. Coupled with the widespread acceptance of murder by dehydration, this enthusiasm for organ transplant becomes truly deadly. Not, I hasten to add, because you can dehydrate someone to death and take his organs. Actually, you can't. The organs are usually harmed by the slow dehydration of the patient. It's just the opposite: Once we have accepted the cruelty of killing by dehydration, the ethicist can point out to us that just bumping the person off sooner and more directly would avoid the distasteful nature of that method and also make usable organs available for transplant. A twofer. Relatives who have accepted, perhaps with some reluctance, killing a loved one by dehydration may be all too susceptible to Fritz's arguments. It's often easier to go on from bad to worse than to go back.

This is true when it comes to death by dehydration. Instead of saying, "Maybe we were wrong," the temptation is to say, "Yes, you're right. We might as well get this over with faster and 'give the gift of life.'" It is also true of vital organ donation itself. It's easier to say, "How can we find means of making more organs available?" than to say, "Maybe this difficulty and the medical facts that lie behind it indicate that we shouldn't have started down this road in the first place."

I urge that we be willing to take the more uncomfortable path, in both cases.

Comments (1)

I will not say that it is logically required that one endorse bare-faced murder if one becomes a real enthusiast for vital organ donation. There are many well-intentioned and even pro-life people who are such enthusiasts. But I will say that unscrupulous bioethicists like Zoe Fritz will be only too happy to use that enthusiasm for their own ends.

Right. The stance of being a real enthusiast for vital organ donation requires that one either look the other way about how difficult it is to be sure a person is dead when their vital organs are usable, or to place unwarranted confidence in "the authorities" about it because "surely they know better than me". The reality is that ordinary doctors have received (at best) rather poor ethical training, for the last 30 years or so, because ever since "bioethics" has been a field of study rather than simply what doctors carry out day to day, it has been run by those who have an interest in twisting the 'ethics' into a program of excusing and promoting new and exciting (sexy) and money-gruabbing activities. (Apparently, nobody ever started a new bioethics program at a university in order to teach doctors to say "no, as we have known for centuries or even millenia, that's immoral.") As for the political authorities, why we have even less reason to be confident in their ethics - many of them have persistently supported abortion (even to partial-birth murder), and promoted direct euthanasia as such, and so on. It is so bad that generally speaking, we are warranted in assuming (with rare exceptions) that if a person is credentialed via a bioethics program, they are out to kill the weak. (The main exceptions being places like the John Paul II Bioethics Center.)

What's scary here is the flip-flop on the explanations being used to support this. It used to be stuff like "we are allowed to let a person die because that is preferable to prolonging his life without hope or benefit". Now it is "it is better for the person dying kill them outright than to just let them die, because that is more merciful (and besides we get the organs so we can be merciful to others as well). "

One wonders how they would react to finding a loving, merciful doctor who frequents bars, sidles up to depressed drunks, convinces them (easily) that "it's all hopeless, it isn't worth it anymore" and takes them off to the 'organ reclamation center' to "do the upright, loving, merciful thing" on behalf of others. People might claim the right to denounce such behavior, but Belgium is showing us that the slippery slope is nearly unavoidable once you get on it: it is a series of easy and small steps from "we can actively kill those who are terminally ill who explicitly ask to die" to "we can kill those who are ill and who implicitly indicate they might want to die in certain circumstances, to "we ought to kill those who use of their organs is not as beneficial as others' use would be.

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