New clinical manual addresses controversial topic of organ donation after euthanasia

A new practical manual addresses the controversial topic of organ donation after euthanasia, providing guidance to clinicians whose patients have requested euthanasia and the desire to offer their organs to others in need. The manual is published in the American Journal of Transplantation.

Around the globe, euthanasia or assisted suicide is increasingly being considered a legal right for patients with certain devastating medical conditions. In some situations, patients who wish to pursue euthanasia may also request that their organs be donated after their death. With this in mind, Jan Bollen, LLM, MD, PhD student, of the Maastricht University Medical Center in the Netherlands, and his colleagues developed a manual for situations in which euthanasia can be combined with organ donation.

"Euthanasia itself remains an ethical subject surrounded by controversy, but the members of our working group attempted to be nonjudgmental regarding this issue," said Bollen. "Since organ donation after euthanasia is legally possible in the Netherlands, we were however convinced it was wise to create a practical manual. Even though it was first intended as a regional manual, it is now being used by various hospitals in the Netherlands. It does not focus on ethical questions, although these should be carefully identified and subsequently addressed." For example, should a physician, when seeing a patient who wishes to undergo euthanasia, address the possibility of organ donation? And what if a patient wants to donate his or her heart by having it removed while under general anesthesia, essentially performing euthanasia by removing the heart?

The manual provides a framework of the medical and logistical aspects of donation after euthanasia within the medical, legal, and ethical boundaries of Dutch law. "If a patient would ask his treating physician to undergo euthanasia and donate organs, our practical manual contributes to the knowledge of this physician that organ donation after euthanasia is a real option, and that he or she knows what steps to follow," said Bollen.