Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands

Abstract

Organ donation after euthanasia has been performed more than 40 times in Belgium and the Netherlands together. Preliminary results of procedures that have been performed until now demonstrate that this leads to good medical results in the recipient of the organs. Several legal aspects could be changed to further facilitate the combination of organ donation and euthanasia. On the ethical side, several controversies remain, giving rise to an ongoing, but necessary and useful debate. Further experiences will clarify whether both procedures should be strictly separated and whether the dead donor rule should be strictly applied. Opinions still differ on whether the patient's physician should address the possibility of organ donation after euthanasia, which laws should be adapted and which preparatory acts should be performed. These and other procedural issues potentially conflict with the patient's request for organ donation or the circumstances in which euthanasia (without subsequent organ donation) traditionally occurs.

Organ Donation After Euthanasia: A Pure Act of Altruism Fulfilling the Patient’s Last Wish

“…Several ethical controversies, such as whether the physician should always inform patients about the possibility of organ donation after euthanasia, which preparatory investigations are allowed, and whether the donor should be informed about matching recipients, are beyond the scope of this article 2.…”

Organ donation after medical assistance in dying or cessation of life-sustaining treatment requested by conscious patients: the Canadian context

“…Netherlands : It is permitted in the Netherlands to donate organs following euthanasia 27 28. So far, 15 patients have requested this procedure 21…”

“…One may question whether applying the DDR in the specific context of MAID or cessation of treatment is the optimal thing to do as suggested by Bollen et al 21 28. If organ donation were permitted following MAID, some would say it is counterproductive to provoke the death of the person with medication and then procure his or her organs.…”

“…There is a dilemma surrounding the matter of informing patients of the possibility of donating organs after MAID 21 28. Not informing patients could prevent them from performing an act they would have wanted to do, while informing them could be seen as pressure to accept donation.…”

Withdrawal of clinically assisted nutrition and hydration decisions in patients with prolonged disorders of consciousness: best interests of the patients and advance directives are the keys

“…Since the 28th of May 2002,5 it is allowed for any adult to give advance directive to authorities in order to engage a procedure of euthanasia (ie, administration by a medical doctor of lethal treatment) in the event of his incompetence. Moreover, euthanasia does not legally and medically exclude organ donation 6. Nevertheless, it must be said that very few people fulfil the entire procedure.…”