Doctors harvesting organs from Canadian patients who underwent medically assiste

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http://news.nationalpost.com/health/doctors-harvesting-organs-from-canadian-patients-who-underwent-medically-assisted-death?__lsa=c5a4-b79b

Doctors harvesting organs from Canadian patients who underwent medically assisted death
Sharon Kirkey

Doctors have already harvested organs from dozens of Canadians who underwent medically assisted death, a practice supporters say expands the pool of desperately needed organs, but ethicists worry could make it harder for euthanasia patients to voice a last-minute change of heart.
In Ontario, 26 people who died by lethal injection have donated tissue or organs since the federal law decriminalizing medical assistance in dying, or MAID, came into effect last June, according to information obtained by the Post. A total of 338 have died by medical assistance in the province.
Most of the 26 were tissue donors, which usually involves eyes, skin, heart valves, bones and tendons.
Bioethicists and transplant experts say people who qualify for assisted dying deserve to be offered the chance to donate their organs. The gesture could bring a profound sense of psychological comfort, they say, provided the request for assisted death and the decision to donate are kept entirely separate.
“If we accept people can make decisions to end life, and we accept the idea of cardiac death being sufficient for organ donation, this should be acceptable,” said Dr. James Downar, a Toronto critical care doctor and co-chair of a Canadian Blood Services committee developing organ donation guidelines for what is being called the “conscious competent patient.”
“The concern that comes up is, could the decision for one drive the decision for the other?”
Ethicists say organ donation could put pressure on those who qualify for assisted suicide to choose death, that the terminally ill “may feel they would better serve society by dying and saving other people’s lives,” Dr. Marie-Chantal Fortin, a transplant nephrologist at the Centre hospitalier de l’Universite de Montreal, and ethicist Julie Allard write in the journal, Clinical Ethics.
Others are asking, what if people agree to donate, but then change their mind about hastening death? Would they feel compelled to follow through with the act, knowing the chosen recipients are waiting for their organs?
“This is a theoretical possibility,” says Jennifer Chandler, a professor in the centre for health law, policy and ethics at the University of Ottawa. “Imagine a situation where the work up is done — people have gone out and done the medical tests and found the recipients and set everything up. And then you change your mind.
“One wonders if perhaps that might create pressure to continue with the MAID,” Chandler said. “It would be very important in these scenarios to make it very clear to people that they can change their mind at any time — that someone shouldn’t stick with MAID just because they feel an obligation, having set the process in motion.”
The issue is so volatile, after Fortin and her co-author concluded organ donation after assisted dying would be ethically acceptable if the person is competent and under no pressure to choose either, for those opposed to euthanasia, “it was like we were vultures,” she said.
“I think it’s really important we keep the public’s trust, in all of this,” Fortin said. “We have to be transparent. And it has to be clear that the two must be kept separate, that there is no pressure to go for MAID to procure organs.”
Organ harvesting after euthanasia is already a reality in Belgium and the Netherlands.