Friday, 9 August 2013

Altruistic assisted suicide - surely you can't be serious?

A Huffington Post report from the US about a terminally ill Michigan woman who wants to die by assisted suicide so she can donate her organs is most disturbing.

We've reported earlier on organ harvesting in Belgium associated with acts of euthanasia, seemingly now an accepted practice:

Belgium becomes world leader in organ removal after euthanasia.


Sherri Muzher has Multiple Sclerosis (MS). The article says that she is terminal. However, as the Multiple Sclerosis Australia website observes: It is generally very difficult to predict the course of MS. The disorder varies greatly in each individual but most people with MS can expect 95% of the normal life expectancy.

Muzher told a US Fox news affiliate: "It would be a nice legacy to give life. ... We ought to be able to make our own decisions, and if that collateral effect means helping others, why would anyone have a problem with that?"

Assisted Suicide remains illegal in Massachusetts. The last attempt to legalise the practice by way of citizen initiated referendum failed in November last year. But this story suggests to the writer that another push may be in the offing through legislative means as recently occurred in Vermont.

While not wanting to play down in any way the difficulties that Sherri Muzher is facing, I cannot help but ask the question: is her offer to donate her organs more about creating sympathy for her wish to die?

The Huffington Post report includes an extended video interview with people pro and con the issue. It's really worth watching. The report also includes an observation by a Medical ethicist Dr. Michael Stellini:
"If we wait too long, she couldn't donate. ... If we do it too early, she's not terminal, and that raises a whole other set of ethical issues. If we're going to allow physician assisted suicide, we'd have to determine a window to make the determination of terminal state, and the end of viability of the organs, and that's when we would do what she is proposing."
This echoes in many ways the chilling observations of Australian UK ethicist, Julian Savulescu:
‘Why should surgeons have to wait until the patient has died as a result of withdrawal of advanced life support or even simple life prolonging medical treatment? An alternative would be to anaesthetize the patient and remove organs, including the heart and lungs. Brain death would follow removal of the heart (call this Organ Donation Euthanasia (ODE))…. Organs would be more likely to be viable, since they would not have sustained a period of reduced circulation prior to retrieval. More organs would be available (for example the heart and lungs, which are currently rarely available in the setting of DCD). Patients and families could be reassured that their organs would be able to help other individuals as long as there were recipients available, and there were no contraindications to transplantation.’

So, if we're going to take this purely utilitarian line that says, 'she wants to die anyway, so why not put her organs to use' we're seriously challenging the conventional wisdom that says that suicide is never a rational response to difficult circumstances. All that's left to us, if we except this line of argument, is to determine what 'difficult circumstances' are acceptable.

Would the 'tired of living' argument be sufficient? What if Sherri Muzher wasn't sick at all?

We would be accepting a causal relationship between killing oneself and organ donation with the implication that self-destruction is a good.

Moreover, even in terms of the assisted suicide laws as they exist in Oregon, Washington and Vermont, this would be a radical change that currently sits outside the law. As Savalescu describes it, it would no longer be assisted suicide (where the doctor prescribes the lethal dose), it would be closer to, if not precisely euthanasia. It would occur, of necessity, in an operating theatre with facilities to handle organ transplants. It may even occur where the recipient(s) of the said organs are prepared in an adjacent theatre for organ reception.

These scenarios not only cast the doctor in the role of killer, but also the medical team in the roles of accessory.

This is madness!


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