Somerville Margaret
School of Medicine, Institute for Ethics & Society, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.
Linacre Q. 2019 Nov;86(4):359-365. doi: 10.1177/0024363919872623. Epub 2019 Sep 10.
If, in jurisdictions with legalized euthanasia, obtaining organs for transplant from euthanized people is allowed, must their organs be taken only or should be allowed to be performed of vital organs? Asked another way, if "Donation after Death" is practiced, why not "Death by Donation?" The article addresses two questions. First, "What issues does connecting euthanasia and organ donation raise?" They include dealing with uncertainty regarding the definition of death, defining what constitutes conscientiously objecting healthcare professionals' involvement in euthanasia, and whether connecting euthanasia and transplantation makes conflicts of interest for healthcare professionals unavoidable. Additional issues raised by death donation include breach of the "dead-donor rule"; what would constitute informed consent to it; and what impact its acceptance would have on important foundational societal values, especially respect for human dignity and human life. The second question is "Why might some people who agree with euthanasia and even organ donation after death by euthanasia find death donation ethically unacceptable?" Considerations again include its harmful impact on upholding respect for human dignity and human life and that the "wisdom of repugnance" could be informing these people's reaction. It is concluded that in order to avoid serious breaches of ethics, organ transplantation and euthanasia should not be linked in any way.
在安乐死合法化的司法管辖区,如果允许从安乐死的人身上获取用于移植的器官,那么是只能摘取他们的器官,还是应该允许摘取重要器官呢?换个说法,如果实行“死后捐赠”,那为什么不实行“因捐赠而死亡”呢?本文探讨了两个问题。首先,“将安乐死与器官捐赠联系起来会引发哪些问题?”这些问题包括应对死亡定义的不确定性、界定出于良心拒服兵役的医疗专业人员参与安乐死的构成要素,以及将安乐死与移植联系起来是否会使医疗专业人员不可避免地产生利益冲突。因捐赠而死亡引发的其他问题包括违反“死亡捐赠者规则”;什么构成对其的知情同意;以及接受它会对重要的社会基本价值观,尤其是对人类尊严和生命的尊重产生什么影响。第二个问题是“为什么一些赞同安乐死甚至赞同安乐死后器官捐赠的人会在伦理上认为因捐赠而死亡不可接受?”考虑因素再次包括其对维护人类尊严和生命尊重的有害影响,以及“厌恶情绪的智慧”可能在影响这些人的反应。结论是,为避免严重违反伦理道德,器官移植和安乐死不应以任何方式联系在一起。