For years, organ transplant ethicists and some in the bioethics community have agitated to change the definition of death from a purely biological determination, to one based in utilitarianism and desired sociological narratives. Why mess with death? Too few organs are donated for transplant, leading to long waiting lines and the deaths of some people who might be saved were organs more readily available.
But why redefine death? The point of this reckless advocacy — although they don’t put it this bluntly — is that there are thousands of perfectly good organs being used by people who really don’t need them anymore, by which they mean patients with profound cognitive impairments who will remain unconscious or minimally aware for the rest of their lives. Why not harvest such patients, this thinking goes, for the benefit of people who could return to normal lives?
The problem is that would break the “dead donor rule,” the legal and moral pact organ transplant medicine made with society promising that vital organs would only be harvested from patients who are truly dead. Hence, if the definition of death were loosened to include, say, a diagnosis of persistent vegetative state, more organs could be obtained — and the dead donor rule could still appear to be honored, deemed essential for transplant medicine to retain the trust of society.
Of course, that would be fiction, and the redefinition actually a betrayal. What these “ethicists” really propose is killing for organs, a view now being promoted in some of the world’s most prestigious medical, science, and bioethical journals. For example, Nature recently editorialized in favor of liberalizing the rules governing brain death.
Currently, brain death requires the irreversible cessation of all functions of the entire brain and each of its constituent parts. Nature’s editorial claimed — without proof — that doctors obey “the spirit but not the letter, of this law. And many are feeling uncomfortable about it.”
As well they should. But the proper answer to unethical practice isn’t to accommodate wrong behavior by redefining it as right. Rather, it is to work to bring actual methods back into proper alignment with legal and ethical practice.
Instead, Nature descends into rank relativism, arguing that “the legal details of declaring death in someone who will never again be the person he or she was should be weighed against the value of giving a full and healthy life to someone who will die without transplant.” Think about the looseness of that language! At minimum, it would mean that those with profound incapacities would be redefined out of the human condition and used as if they were mere natural resources.
Only a week later, an article by NIH bioethicist F.G. Miller, published in the Journal of Medical Ethics, opined that the ethical proscription against killing by doctors is “debatable,” and asserted that doctors should be able to harvest organs from living patients when planning to withdraw life support:
“In at least the near future it is probable that we will continue to muddle through [with the current system]. In the longer run, the medical profession and society may, and should, be prepared to accept the reality and justifiability of life terminating acts in medicine in the context of stopping life sustaining treatment and performing vital organ transplantation.”
In that seductive prescription is the end of human equality and the obliteration of universal rights.
It is important to stress that doctors are not currently harvesting the organs of people in PVS, and surely most would never do so. But that doesn’t mean it can’t happen here. Richard John Neuhaus once wrote, “Thousands of medical ethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable, until it is finally established as the unexceptionable.”
That process is steaming full speed ahead in the related fields of organ transplantation and biotechnology. The only way to stop this dehumanizing agenda is to take notice and push back before it is too late. Some things should ever and always be unthinkable.
CBC Special consultant Wesley J. Smith is a Senior Fellow in Human Rights and Bioethics for the Discovery Institute.