This is a very touchy subject here in America. It seems that nobody wants to address the issue. The physicians are still hesitant to consult palliative care. It could be because it represents failure of modern medicine for some. Privately, a lot of people are in favor of euthanasia, or assisted suicide, for chronically ill people. How often have you heard, If one day I am in this or that condition please pull the plug. In some countries, especially in Europe, euthanasia is legal, not without creating controversy thought. One specific country has found a way to make it more compassionate. In Belgium where euthanasia is legal, they use organs from the chronically ill that are deemed good quality for transplantation. Of course, they don’t do that with cancer patients. In a span of three years, from January 2007 to December 2009 they were able to recover 4 lungs suitable for lung transplant according to Dirk van Raemdonck and colleagues. During that span they also recovered kidneys and livers who were good enough for organ transplants.
How does it work?
Obviously, everything happens in a control environment and it works the same way as donation after cardiac death. The patient wishing for euthanasia, who has a non-malignant disorder, is given the drugs by a physician. Once the heart stops beating, the patient is pronounced on cardiopulmonary criteria by three independent physicians. Then the patient is brought to the OR where they start the surgery to recover the organs.
Even if euthanasia would become legal here in this country, I don’t expect many potential organ donor since those patients, for the most part, have been sick for years and their organs may not be good. But, it is something to keep in mind for the future and will certainly require a comprehensive ethical debate. Not sure we are ready for that here.