beware your heart

there are urban legends in the US about patients waking up on the operating table as doctors prepare to take out their organs, or that doctors will "hurry you along" to die to take them out, and a recent story in USA today says that killing people (by euthanasia) to take out their organs is becoming more popular: and is increasingly discussed at medical conferences as a possibility:

At international medical conferences in 2018 and 2019, I listened as hundreds of transplant and critical care physicians discussed “donation after death.” This refers to the rapidly expanding scenario in Canada and some Western European countries whereby a person dies by euthanasia, with a legalized lethal injection that she or he requested, and the body is then operated on to retrieve organs for donation.

At each meeting, the conversation unexpectedly shifted to an emerging question of “death by donation” — in other words, ending a people’s lives with their informed consent by taking them to the operating room and, under general anesthesia, opening their chest and abdomen surgically while they are still alive to remove vital organs for transplantation into other people...

Recently, the New England Journal of Medicine (NEJM) published an article by two Canadian physicians and an ethicist from Harvard Medical School, who contended it might be ethically preferable to ignore the dead donor rule if patients declare they want to die in order to donate their organs.

ah, the NEJM, who published a dozen pro euthanasia articles in the early 1990's that insisted everything was hunky dorey in the Netherlands so why not copy their practice. The problem? They ignored the many reports in the lay press and in the medical literature that the guidelines were not followed and most cases were not reported, but hey, as the editor assured me, these articles were "opinions" and so didn't have to be factually accurate.

the USA Article continues:

While literally “giving yourself” to others might seem commendable at first glance, let’s discuss three downstream considerations to abandoning the dead donor rule.

►People with physical and mental disabilities have expressed that they feel stigmatized and that society devalues their lives. Would this send them a not-so-subtle message to get out of the way and do something noble with their healthy organs?

►How quickly would we see expansion whereby those who can’t speak for themselves are included as donors?

►What does it mean for all of us when our healers — physicians — are in a position that directly overrides nearly 2,500 year-long prohibitions against taking life?

what happens is that a small minority of physicians quickly decide they will follow the newfangled Oath of Lasagna instead of the Hippocratic oath, a modern oath which insists" If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God."

in other words, they will not "play at god", they will become god, and assume they have the power of life and death over those under their care.

And if you don't think that this is a frightening idea to poor and minority patients you are naive. Tuskegee experiment, anyone? and this is why minorities often refuse living wills or refuse to go along with "end of life" decisions pushed onto them by the establishment physicians (something that is lamented about in many medical journals who can't understand why patients who face prejudice in their daily life, including at many medical establishments, won't just let some strange doctor have the power of life and death over them or their loved ones).

and, as the USAToday article notes: it's not just terminal patients who face this subtle prejudice:

 Consider the case of Ben Mattlin, who suffers from spinal muscular atrophy. In a 2012 column for the New York Times, he wrote of the “thin and porous border between coercion and free choice” for those who feel devalued. On the subtle erosion of his autonomy, he wrote: “You also can’t truly conceive of the many subtle forces (to die) — invariably well meaning, kindhearted, even gentle, yet as persuasive as a tsunami — that emerge when your physical autonomy is hopelessly compromised.”

what started me on this subject was not the USA today article, but one on StrategyPage, about China. At the end of the discussion of China's economy, China's aggression in the West Philippine sea, and why Hong Kong's population is demonstrating against them, they have this small paragraph:

June 17, 2019: An international tribunal released the results of its investigation into Chinese organ transplant activity. This is not a new problem. At the end of 2014 China announced that it would stop taking transplant quality organs from dead (usually executed) prisoners as of 2015.

Many Chinese and foreigners believed that this profitable organ trade would simply go underground and become another source of corruption. .

Corruption in China? Who wudda thot?

Some of the organs are from executed prisoners, but what about the others? Is there an illegal underground "pay for organ" service, as we see here in the Philippines? or is something more cynical going on?

Since China still executes hundreds of criminals each year, and has thousands of political prisoners, who often go into prison camps and just disappear, there always seems to be available organs for transplant in China.

For years desperate, and well heeled, foreigners come to China, got their life-saving transplant, and noticed that there are a lot of military personnel working in the hospitals. ..

..The Chinese government still insists there is no government involvement in this transplant industry, yet the operations continue and may be closer to 100,000 transplants in some years.

 Sigh.

Wikipedia even has a page on the harvesting of organs from Falun Gong prisoners, whose only crime is to belong to a forbidden Buddhist sect. Dean Koontz wrote a horror novel about this practice, but as a whole, few in the west seem upset at the practice and few even protested when a rich New York writer's book about getting a kidney in China makes light of the question of who died was killed to sell his brother a kidney.

China is a rogue nation in these matters, of course (I mean, they have a million Muslims in re education camps without many in the west protesting about it).

But when Canada starts normalizing the practice of killing people for organs, I think the problem is a a prediction of things to come in the USA.
from https://spectator.org/canada-conjoins-euthanasia-and-organ-harvesting/

ow do you convince society to embrace euthanasia as a means of attaining utilitarian benefit — while also convincing yourselves that your culture remains both moral and compassionate? Once you get past the squeamishness of allowing doctors to kill patients, it isn’t that difficult: First, legalize euthanasia of the seriously ill and disabled. Once the community becomes comfortable with doctors committing homicide as a means of eliminating suffering, you next allow those who want to be killed to donate their organs. After all, they won’t need their livers anymore, so why not let others have them? Next, ensure that the potential of euthanasia to add to the organ supply becomes well known, both to normalize doctor-administered death and to induce people to believe they or a loved one might personally benefit from doctors killing the sick. Finally, over time, you expand euthanasia/organ donation eligibility to patients who are far from death, such as those with neuromuscular disabilities or psychiatric illnesses — better organs, don’t you know — justifying it as you go along with soothing words of respecting autonomy and preventing suffering. Lest any reader believe that I am conjuring a paranoid dystopian fantasy, this very scenario consumed the medical and organ transplant ethics of the Netherlands and Belgium, nations in which patients with mental illnesses and other diseases are admitted to hospitals, killed by lethal injection, and then wheeled immediately into a surgical suite for organ harvesting.

When I bring up these facts in domestic debates about assisted suicide, supporters of doctor-prescribed death sniff that the Netherlands and Belgium are not the United States, and that such crass utilitarian exploitation of the despairing would never happen here. But why? Once we deem certain categories of people to be killable — which is precisely what legalizing assisted suicide and euthanasia does — it becomes all too easy to conclude, as Belgians and Netherlanders have, that since these patients want to die we might as well benefit societally from their deaths.

That is precisely what happened in Canada,