In 1992, my friend Frances committed suicide on her 76th birthday. Frances was not terminally ill. She had been diagnosed with treatable leukemia and needed a hip replacement. Mostly, though, she was depressed by family issues and profoundly disappointed at where her life had taken her.
Something seemed very off to me about Frances’s suicide. So I asked the executor of her estate to send me the “suicide file” kept by the quintessentially organized Frances and was horrified to learn from it that she had been an avid reader of the (now defunct) Hemlock Quarterly, published by the aptly named Hemlock Society (which was since merged into the assisted-suicide advocacy group, Compassion and Choices). The HQ taught readers about the best drugs with which to overdose and gave precise instructions on how to ensure death with a plastic bag—the exact method used by Frances to end her life.
I was furious. Frances’s friends had known she was periodically suicidal and had intervened to help her through the darkness. The Hemlock Society had pushed Frances in the other direction, giving her moral permission to kill herself and then teaching her how to do it. This prompted the first of the many articles I have written over the years against assisted-suicide advocacy. It appeared in the June 28, 1993, Newsweek and warned about the cliff towards which assisted suicide advocacy was steering our society:
We don’t get to the Brave New World in one giant leap. Rather, the descent to depravity is reached by small steps. First, suicide is promoted as a virtue. Vulnerable people like Frances become early casualties. Then follows mercy killing of the terminally ill. From there, it’s a hop, skip, and a jump to killing people who don’t have a good “quality” of life, perhaps with the prospect of organ harvesting thrown in as a plum to society.
The other shoe—“organ harvesting”—has now dropped. Euthanasia was legalized in Belgium in 2002. It took six years for the first known coupling of euthanasia and organ harvesting, the case of a woman in a “locked in” state—fully paralyzed but also fully cognizant. After doctors agreed to her request to be lethally injected, she asked that her organs be harvested after she died. Doctors agreed. They described their procedure in a 2008 issue of the journal Transplant International:
This case of two separate requests, first euthanasia and second, organ donation after death, demonstrates that organ harvesting after euthanasia may be considered and accepted from ethical, legal, and practical viewpoints in countries where euthanasia is legally accepted. This possibility may increase the number of transplantable organs and may also provide some comfort to the donor and her family, considering that the termination of the patient’s life may be seen as helping other human beings in need for organ transplantation.
The idea of coupling euthanasia with organ harvesting and medical experimentation was promoted years ago by the late Jack Kevorkian, but it is now becoming mainstream. Last year, the Oxford bioethicist Julian Savulescu coauthored a paper in Bioethics arguing that some could be euthanized, “at least partly to ensure that their organs could be donated.” Belgian doctors, in particular, are openly discussing the nexus between euthanasia and organ harvesting. A June 10 press release from Pabst Science Publishers cited four lung transplants in Leuven from donors who died by euthanasia.
What’s more, Belgian doctors and bioethicists now travel around Europe promoting the conjoining of the two procedures at medical seminars. Their PowerPoint presentation touts the “high quality” of organs obtained from patients after euthanasia of people with degenerative neuro/muscular disabilities.
Coupling organ donation with euthanasia turns a new and dangerous corner by giving the larger society an explicit stake in the deaths of people with seriously disabling or terminal conditions. Moreover, since such patients are often the most expensive for whom to care, and given the acute medical resource shortages we face, one need not be a prophet to see the potential such advocacy has for creating a perfect utilitarian storm.
Some might ask, if these patients want euthanasia, why not get some good out of their deaths? After all, they are going to die anyway.
But coupling organ harvesting with mercy killing creates a strong emotional inducement to suicide, particularly for people who are culturally devalued and depressed and, indeed, who might worry that they are a burden on loved ones and society. People in such an anguished mental state could easily come to believe (or be persuaded) that asking for euthanasia and organ donation would give a meaning to their deaths that their lives could never have.
And it won’t stop there. Once society accepts euthanasia/organ harvesting, we will soon see agitation to pay seriously disabled or dying people for their organs, a policy that Kevorkian once advocated. Utilitarian boosters of such a course will argue that paying people will save society money on long-term care and allow disabled persons the satisfaction of benefiting society, while leaving a nice bundle for family, friends, or a charitable cause.
People with serious disabilities should be alarmed. The message that is being broadcast with increasing brazenness out of Belgium is that their deaths are worth more than their lives.
Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism, a lawyer for the Patients Rights Council, and a special consultant for the Center for Bioethics and Culture.