Assuntos
Eutanásia/legislação & jurisprudência , Futilidade Médica/psicologia , Competência Mental/legislação & jurisprudência , Assistência Terminal/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Bélgica/epidemiologia , Criança , Pré-Escolar , Tomada de Decisões , Eutanásia/psicologia , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Futilidade Médica/legislação & jurisprudência , Países Baixos/epidemiologia , Autonomia Pessoal , Assistência Terminal/ética , Obtenção de Tecidos e Órgãos/éticaRESUMO
Euthanasia is categorically prohibited in almost all countries throughout the world. In Belgium and the Netherlands, combining euthanasia and subsequent organ donation in a so-called donation after circulatory-death (DCD) procedure is feasible on legal and medical grounds, and is increasingly gaining social and ethical acceptance. However, heart transplantation after DCD is currently not performed in Belgium and the Netherlands after euthanasia due to concerns surrounding the prolonged warm ischemia time associated with DCD and its effect on subsequent heart function. A number of patients who undergo euthanasia explicitly express their wish to donate their organs in a "living organ donation" procedure, which then causes death. Assuming that euthanasia is permitted, as expressed in Dutch and Belgian legislation, this exploratory article addresses whether it is legally and ethically sound to donate organs, especially the heart, as a living donor and to perform euthanasia in the same procedure in a patient who fulfills the due diligence requirements for euthanasia. Organ donation euthanasia (ODE) would then cause death by the associated surgical procedure, and in addition would improve the quality of the other donated organs, a procedure that would fully respect the patient's autonomy.
Assuntos
Eutanásia/legislação & jurisprudência , Doadores Vivos/ética , Transplante de Órgãos/legislação & jurisprudência , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Bélgica , Humanos , Países Baixos , Obtenção de Tecidos e Órgãos/ética , Isquemia Quente/legislação & jurisprudênciaRESUMO
Organ donation after euthanasia has been performed more than 40 times in Belgium and the Netherlands together. Preliminary results of procedures that have been performed until now demonstrate that this leads to good medical results in the recipient of the organs. Several legal aspects could be changed to further facilitate the combination of organ donation and euthanasia. On the ethical side, several controversies remain, giving rise to an ongoing, but necessary and useful debate. Further experiences will clarify whether both procedures should be strictly separated and whether the dead donor rule should be strictly applied. Opinions still differ on whether the patient's physician should address the possibility of organ donation after euthanasia, which laws should be adapted and which preparatory acts should be performed. These and other procedural issues potentially conflict with the patient's request for organ donation or the circumstances in which euthanasia (without subsequent organ donation) traditionally occurs.
