Assisted Suicide, Organ Donation & the Devaluing of the Human Person

Heather Ross could not hold her husband Bob's hand while he died because he was being prepped for surgery. His organs needed to be removed as close to the moment of death as possible to ensure the best outcome for their transplantation. Bob Blackwood was one of the first patients in Quebec to donate organs after medical aid in dying (MAID) was legalized in Canada in 2016.1

While more than 6,700 people have chosen to end their lives through medically assisted suicide in Canada in the past three years, only a tiny fraction, about 30, also chose to donate their organs. Most people do not qualify because of the nature of their disease. And most of those who do qualify would prefer to die at home.

The Netherlands has tried a workaround for the competing goals of dying through assisted suicide at home and being able to donate viable organs: The patient takes medication that will put him in a deep sleep while still at home and surrounded by loved ones. Then a medical team transports the patient to the hospital, where he will receive a lethal injection, closely followed by organ removal. About four hours later, the body will be returned home. Rather than a so-called death with dignity, this is a staged "death," allowing the actual death to occur in a more convenient place.

In light of the Dutch solution, which doesn't sit well with many people, the Journal of the Canadian Medical Association published a set of guidelines in June that lays out how to talk to patients seeking assisted suicide about whether they want to donate their organs.2 The Canadian guidelines say that the decision to choose to die through MAID or by the withdrawal of life-sustaining measures "must be separate from, and must precede, the decision to donate."

While the guidelines go to great lengths describing how conversations about organ donation should be carried out so as to protect patient autonomy, they seem to neglect a more important conversation. Wesley Smith, a vocal opponent of euthanasia and assisted dying, said in an article in The American Spectator, "I scoured the document, and do you know what I didn't find? Any requirement that ­patients who ask for euthanasia receive suicide prevention or treatment to help them overcome the desire to die."3

As a teen and college student, I served as a peer helper and a freshmen orientation mentor. As an adult, I have volunteered to work with teens. In all cases, I had training in what to do if someone was suicidal. I was legally required to report the suicidal person to someone who could help, in the hope that the person could be dissuaded from committing suicide. But what medically assisted suicide coupled with organ donation communicates, without explicitly saying so, is that maybe some people aren't worth helping, but their organs are worth harvesting.

Means to an End

With the first successful kidney transplant in 1954 came a debate over what it means to harvest the parts of a person's body. The first transplant came from a living donor, but things became more complicated with the first heart, liver, and pancreas transplants in 1967. One year later, in 1968, the definition of death was changed to include so-called brain death, largely to facilitate organ transplantation.

We can intuitively sense the tug-of-war involved with organ transplantation. On the one hand, there's something troubling about disassembling a dead body, something that speaks to the same intuitions that keep laws against desecrating a corpse on the books. On the other hand, the idea of giving of oneself so that another may live is noble. In the case of organ donation after death, it isn't self-sacrifice in the sense that one person agrees to die in order to save another (at least it shouldn't be). But as a member of President Bush's Council on Bioethics put it, the dying person and his family are sacrificing something in allowing their loved one's body to become disaggregated.4

Organ transplantation can easily slip from altruism into exploitation, or from "donation" to "harvesting." Donation implies an altruistic act by which one person freely gives of himself to benefit another. Harvesting implies a utilitarian act by which one person is used as the means of benefiting another.

The latter also implies a fractured, or dualistic, view of human beings, something Nancy Pearcey writes about in her book Love Thy Body (Baker Books, 2018). This fractured view splits the person in two, locating his identity in his mental state—which is considered the true "self" in our Gnostic-inspired culture—and regarding the body as mere flesh, something that can be used as a means to an end, whether that end be autonomy, pleasure, identity construction, or anything else the "self" decides it wants. When a person's mind is gone, his body, at least in this worldview, can then be used as a means to someone else's ends because it no longer houses the true person.

The question then arises: Is there a point at which the body can validly be subjected to a cost-versus-benefit analysis? Say the mental capacity of a particular person has slipped below a certain level; can we then deem him to be worth more dead than alive? Can we establish criteria for when a life has become unworthy of life, as the Nazis did?

Canada's coupling of assisted suicide with organ donation may seem to offer an opportunity to combine autonomy with altruism: a patient freely decides that his life is not worth living, while also giving of himself so that another may live. But in legalizing physician-assisted suicide, society has implicitly agreed with the suicidal person that his life is not worthy of life. And in coupling that view with organ donation, it affirms that such a person is actually worth more dead than alive. As Pearcey writes in Love Thy Body, "When a society accepts the practice, it absorbs the worldview that justifies it."

Buying & Selling Body Parts

To see how this utilitarian view of human beings plays out in real life, we can look at China's organ transplantation practices.

Last June, a tribunal initiated by the International Coalition to End Transplant Abuse in China concluded that the Chinese regime has for years been illegally harvesting organs from prisoners of conscience, particularly members of Falun Gong, and that it has done so even after promising to end the practice in 2015. Furthermore, China likely extricates those organs while the prisoners are still living, being kept alive either on an ECMO (extracorporeal membrane oxygenation) machine or through more gruesome methods. The evidence was so overwhelming that the tribunal provided an interim judgment six months earlier than expected, stating that it had determined "unanimously, and [was] sure beyond reasonable doubt" that China has continued to harvest organs from prisoners of conscience and members of religious minorities.5

The Chinese government began imprisoning members of the Falun Gong in 1999, and the tribunal said it was certain that imprisoned Falun Gong members were a principal source of organs. The tribunal also heard anecdotal stories that China was obtaining organs from imprisoned Tibetans, Uyghurs, Kazakhs, Christians, and members of Christian-inspired cults as well.6 This combination of oppressing religious minorities and harvesting their organs has led to a brisk and lucrative organ trade. Unlike the U.S., Canada, or the U.K., where wait times for an organ can be years, people in China can receive a new organ in two weeks. Furthermore, undercover journalists found that recipients could schedule their organ transplant surgeries in advance, which is only possible if the hospital knows ahead of time that a matching organ will be available.

Gift & Giver

Although many in our society act as though the mental self is distinct from the physical body, bioethicist Gilbert Meilaender has pointed out that a "gift can never be entirely severed or alienated from the giver." Thus, what an organ donor gives "is not simply an organ but himself or herself." This is why people who have received organs from donors often subsequently bond with the donors' families. Although the body itself is merely flesh, it is the conduit through which we can know each other and interact with the world, and that makes the body an inextricable part of the person. The parts do not make the whole, but the whole is comprised of integrally related parts.7

Over the past sixty years, organ transplantation has been a source of renewed life to many suffering from organ failure, but where the practice has been abused, it has also cost the lives of those deemed unworthy of life. It can be a free gift that connects people within a community, or it can be a means of commodifying human beings. The difference lies in how we view the person: Does he or she have intrinsic moral worth, or has some arbitrary standard determined that he is worth more dead than alive?

Notes
1. The Globe and Mail (June 3, 2019): theglobeandmail.com/canada/article-canadian-blood-services-releases-first-set-of-national-guidelines-for.
2. "Deceased organ and tissue donation after medical assistance in dying and other conscious and competent donors: guidance for policy" CMAJ (June 3, 2019): cmaj.ca/content/cmaj/191/22/E604.full.pdf.
3. Wesley Smith, "Canada Conjoins Euthanasia and Organ Harvesting," The American Spectator (June 8, 2019): https://spectator.org/canada-conjoins-euthanasia-and-organ-harvesting.
4. The President's Council on Bioethics, Session 5, "Toward a 'Richer Bioethics': Are we our bodies?" (July 12, 2002): https://bioethicsarchive.georgetown.edu/pcbe/transcripts/jul02/session5.html.
5. Benedict Rogers, "The Nightmare of Human Organ Harvesting in China," The Wall Street Journal (Feb. 5, 2019): wsj.com/articles/the-nightmare-of-human-organ-harvesting-in-china-11549411056.
6. Owen Bowcott, "China is harvesting organs from detainees, tribunal concludes," The Guardian (June 17, 2019): theguardian.com/world/2019/jun/17/china-is-harvesting-organs-from-detainees-uk-tribunal-concludes.
7. Gilbert Meilaender, "The Giving and Taking of Organs," First Things (March 2008): firstthings.com/article/2008/03/001-the-giving-and-taking-of-organs.

has an M.S. in chemistry from the University of Texas at Dallas, and an M.A. in bioethics from Trinity International University. She resides in Dallas and currently works as a freelance science writer and educator.

This article originally appeared in Salvo, Issue #51, Winter 2019 Copyright © 2020 Salvo | www.salvomag.com https://salvomag.com/article/salvo51/body-discount