Catholic, Jewish, and Muslim leaders sign declaration against euthanasia, physician-assisted suicide

By Hannah Brockhaus
Vatican City, Oct 28, 2019 / 12:15 pm (CNA).

Leaders of Christianity, Judaism, and Islam presented a signed declaration to Pope Francis Monday expressing their total opposition to euthanasia and any form of physician-assisted suicide, as well as voicing their support of palliative end-of-life care.

The document was signed at the Vatican Oct. 28 by Archbishop Vincenzo Paglia, head of the Pontifical Academy for Life, along with representatives of the Jewish and Islamic faiths. It was given to Pope Francis during an audience.  

The position paper states that the three Abrahamic religions “oppose any form of euthanasia – that is the direct, deliberate and intentional act of taking life – as well as physician assisted suicide – that is the direct, deliberate and intentional support of committing suicide – because they fundamentally contradict the inalienable value of human life, and therefore are inherently and consequentially morally and religiously wrong, and should be forbidden without exceptions.”

The paper also affirms the right of healthcare workers to not be coerced or pressured into directly or indirectly assisting in the intentional death of a patient through assisted suicide or any form of euthanasia, especially when doing so would violate the provider’s religious beliefs.

Even if accepted by the local legal system, “moral objections regarding issues of life and death certainly fall into the category of conscientious objection that should be universally respected,” the paper declares.

Healthcare providers, it notes, have the responsibility “to provide the best possible cure for disease and maximal care of the sick.”

The idea for the declaration came from Rabbi Avraham Steinberg, an Israeli medical ethicist, who proposed it to Pope Francis. The pope entrusted the project to the Pontifical Academy for Life, which organized an interreligious committee to create the document.

In the nearly 2,000-word position paper, it is stated that the Catholic, Jewish, and Islamic faiths “share common goals and are in complete agreement in their approach to end-of-life situations.” It also notes that these principles are sometimes in conflict with “current secular humanistic values and practices.”

The preamble to the report notes that “the moral, religious, social and legal aspects of the treatment of the dying” are among the most complex and most widely discussed in medicine today.

The issues surrounding the end of life include “difficult dilemmas,” which have increased in recent years, it argues, because of scientific-technological developments, changes in the patient-doctor relationship, cultural changes, and a growing scarcity of resources related to the expense of medical care.

These dilemmas are not primarily medical or scientific, but “social, ethical, religious, legal, and cultural,” it declares, adding that human intervention in the form of medical treatment and technologies “are only justified in terms of the help they can provide.”

“Therefore, their use requires responsible judgment about when life-sustaining and life-prolonging treatments truly support the goals of human life, and when they have reached their limits,” it claims.

The declaration states that “when death is imminent despite the means used, it is justified to make the decision to withhold certain forms of medical treatments that would only prolong a precarious life of suffering.”

However, both medical providers and society should respect the wish of a dying patient to prolong or preserve his/her life even for an additional short period of time by clinically appropriate medical measures,” it continues.

The Catechism of the Catholic Church teaches that a person may legitimately choose to discontinue medical procedures which are “over-zealous,” meaning “burdensome, dangerous, extraordinary, or disproportionate to the expected outcome..”

The position paper defines a “dying patient” as someone who has “a fatal, incurable, and irreversible disease” and is at a stage when their death will likely occur within a few months “as a result of the disease or its directly related complications, despite the best diagnostic and therapeutic efforts.”

The report offers encouragement and support for professional palliative care for everyone, everywhere and to commend laws and policies which protect the dignity of a dying person.

It also declares a commitment to engage with communities on the issue of bioethics, and to raise public awareness about palliative care.

The paper states a belief that society has an obligation to help patients not to feel like a burden and to know the value and dignity of their life, “which deserves care and support until its natural end.”

The declaration also calls on policymakers and healthcare providers to familiarize themselves with the perspective and teaching of these religions in order to better provide medical assistance in accord with their patients’ beliefs.

“While we applaud medical science for advances to prevent and cure disease, we recognize that every life will ultimately experience death,” it states. “Care for the dying is both part of our stewardship of the Divine gift of life when a cure is no longer possible, as well as our human and ethical responsibility toward the dying (and often) suffering patient.”

h/t to CNA

Organ donation and euthanasia make a good team in Ontario

h/t to BioEdge by Michael Cook | 20 Oct 2019 | 

There is a startling statistic tucked away in Ontario’s September quarter euthanasia statistics. A total of 519 people were euthanised from July 1 to September 30.

Nothing too surprising.

But of the total euthanised, it appears, from government’s sketchy summary, 30 donated organs. In other words, somehow the euthanising doctor and the transplant surgeons coordinated their efforts so that these people could give their organs to others. The time period is unclear. 

Presumably the donation was not the cause of death, as this is illegal under Canada’s euthanasia legislation. But there is pressure from doctors to change this. A year ago two Ontario physicians and Robert Truog, a bioethicist from Harvard Medical School, published an article in the New England Journal of Medicine listing all the advantages of “organ donor euthanasia”.

It would be necessary to do away with the dead donor rule – that a patient must be dead before donating. In Canada a euthanasia death must be caused by the administration of a “substance”, not by organ retrieval. The law would have to be amended to take account of this medical and ethical development.

This has been bitterly criticised, of course. Last month Dr E. Wesley Ely, of Vanderbilt University, published an opinion piece in the journal Intensive Care Medicine. He argued: “When physicians are participating in a procedure designed to take a person’s life, will patients feel 100% certain that their physician is firmly on the side of healing? What message does it send about the value of every human life when physicians endorse the exchange of one life for another? What effect has it already had on physicians complicit in such death-causing procedures?”

Michael Cook is editor of BioEdge

Bioethicists defend euthanasia for mentally ill

by Xavier Symons | 9 Oct 2019 | h/t Bioedge

A new edition of the American Journal of Bioethics explores the theme of euthanasia for mentally ill persons. Several well-known commentators on euthanasia argue that in principle euthanasia should not be prohibited for people suffering from severe psychiatric disorders. 

The journal discussion is built around a target article by Brent Kious and Marget Battin from the University of Utah. Battin is a long-time proponent of voluntary euthanasia, while Kious is a psychiatrist who specialises in severe and persistent mental illness. The authors argue that euthanasia for the mentally ill is morally indistinct from euthanasia for physical terminal illness: 

“We think it is clear that the suffering associated with mental illnesses can sometimes be as severe, intractable, and prolonged as the suffering due to physical illnesses. Accordingly, it seems to us that if severe suffering can justify [physician assisted dying] for some persons with terminal physical illnesses, it should justify [physician assisted dying] for some persons with mental illnesses, too. Call this the parity argument.” 

To resist the parity argument, some scholars claim that terminality (i.e., the presence of a terminal illness) is morally relevant as patients who request euthanasia are dying already. Yet Kious and Battin argue that suffering, not terminality, is the ultimate justification that motives lawmakers to legalise euthanasia: “Terminality is...merely a safeguard, and not a rationale, for [physician assisted dying]”.

Other scholars argue that persons with mental illness lack the capacity to make decisions about ending their own life. Kious and Battin acknowledge that severe mental illness can greatly affect capacity, but they suggest that this does not rule out the possibility that some persons with severe psychiatric disorders are capable of making an autonomous decision to end their life. Indeed, in some cases we may be denying competent persons the right to a humane death:  

“by forbidding [physician assisted death] in [cases of] mental illness we could [be denying] much-needed succor to a person who is suffering severely and whose request for death is reasonable and made with full capacity”.

While several of the open peer commentaries are supportive of Kious and Battin’s basic proposal, a commentary by Charles Foster (University of Oxford) takes the parity argument in the opposite direction. Foster argues that the parity argument is in fact a reason to prohibit euthanasia all together: 

“Kious and Battin are right to assert that there is no distinction of substance between physical and psychiatric suffering, and that the presence of psychiatric suffering does not necessarily connote incapacity (although in practice it often will)...[yet the authors] have reached precisely the wrong conclusion using, in part, precisely the right reasoning. The right conclusion is not that the ambit of legally sanctioned physician-assisted suicide (PAS) should be widened, but that it should be narrowed: Indeed, PAS should be unlawful”.

IVF 'mix up': US couple say they gave birth to wrong children

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h/t The BBC News website

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Image captionThe couple said they turned to IVF after years of trying to have children

An Asian couple who tried to conceive through IVF has claimed that a mix-up at a California fertility clinic left them pregnant with the wrong children.

A lawsuit filed by the couple in New York states that the couple was shocked to give birth to two boys who were not of Asian descent, US media reported.

The lawsuit says DNA tests confirmed the children were not related to the couple and they relinquished custody.

The fertility clinic has not commented on the allegations.

The couple - identified in the lawsuit only as AP and YZ to minimise the "embarrassment and humiliation" - say they tried for years to get pregnant before spending more than $100,000 (£80,000) on the IVF, or in vitro fertilisation, including medication, laboratory fees, travel and other costs.

IVF is the process of fertilising an egg outside of the woman's body, before returning it to the womb to grow and develop.

The lawsuit, filed in the Eastern District of New York last week, accuses CHA Fertility and two men identified as its co-owners and directors of offences including medical malpractice and intentional infliction of emotional distress.

It reportedly notes that after giving birth on 30 March, the couple "was shocked to see that the babies they were told were formed using both of their genetic material did not appear to be".

There were earlier signs that things were amiss when a scan revealed they were expecting boys, despite the fact that the doctors had said they did not use male embryos during the treatment.

Doctors reportedly told the couple that the scan was inaccurate, before they went on to have the baby boys in April. In addition to not being related to the couple, the children were not related to each other, according to the lawsuit.

On its website, CHA Fertility says it delivers the "highest degree of personalized care...with the utmost sense of duty".

The BBC has contacted the company for comment.

Lawyers for the couple told the BBC their clients suffered from "the grossly negligent and reckless conduct of CHA fertility".

"Our goal in filing this lawsuit is to obtain compensation for our clients' losses, as well as to ensure that this tragedy never happens again," the lawyers said.

New Vatican document says gender theory is 'cultural and ideological revolution'

Vatican City, Jun 10, 2019 / 08:35am h/t CNA

A Vatican department has issued a sweeping denunciation of so-called gender theory, and affirmed the principles of human dignity, difference, and complementarity.  

“In all such [gender] theories, from the most moderate to the most radical, there is agreement that one’s gender ends up being viewed as more important than being of male or female sex,” the Congregation for Catholic Education wrote June 10, in a new document entitled “Male and Female He Created Them.”

“The effect of this move is chiefly to create a cultural and ideological revolution driven by relativism, and secondarily a juridical revolution, since such beliefs claim specific rights for the individual and across society.”

The document says it aims to set out an intellectual framework “towards a path of dialogue on the question of gender theory in education.”

Published at the beginning of “Pride Month,” during which many cities and corporations mark the campaign of LGBT advocacy, the document says that the Church teaches an essential difference between men and woman, ordered in the natural law and essential to the family and human flourishing.

“There is a need to reaffirm the metaphysical roots of sexual difference, as an anthropological refutation of attempts to negate the male-female duality of human nature, from which the family is generated,” the document explains.

“The denial of this duality not only erases the vision of human beings as the fruit of an act of creation but creates the idea of the human person as a sort of abstraction who ‘chooses for himself what his nature is to be.’”

The text, signed by Cardinal Giuseppe Versaldi, prefect of the Congregation for Catholic Education, outlines the philosophical origins of the gender theory movement, and notes the broad movement to enshrine its distinct anthropology in policy and law.

The Congregation explains that, beginning in the middle of the twentieth century, a series of studies were published which proposed that external conditioning had the primary determinative influence on personality. When such studies were applied to human sexuality, the document says, they did so with a view to demonstrating that sexuality identity was more a social construct than a given natural or biological fact.

“These schools of thought were united in denying the existence of any original given element in the individual, which would precede and at the same time constitute our personal identity, forming the necessary basis of everything we do.”

“Over the course of time, gender theory has expanded its field of application. At the beginning of the 1990s, its focus was upon the possibility of the individual determining his or her own sexual tendencies without having to take account of the reciprocity and complementarity of male-female relationships, nor of the procreative end of sexuality,” the document says.

The result was a “radical separation between gender and sex, with the former having priority over the later.”

The problem with this theory, according to the Congregation, is not the distinction between the two terms, which can be properly understood, but in the separation of the two from each other.

“The propositions of gender theory converge in the concept of ‘queer’, which refers to dimensions of sexuality that are extremely fluid, flexible, and as it were, nomadic.”

The result of this ideological trend, according to the Congregation’s assessment, is an undermining of the family.

“[In gender theory] the only thing that matters in personal relationships is the affection between the individuals involved, irrespective of sexual difference or procreation which would be seen as irrelevant in the formation of families.”

“Thus, the institutional model of the family (where a structure and finality exist independent of the subjective preferences of the spouses) is bypassed, in favor of a vision of family that is purely contractual and voluntary.”

The document said that despite the challenges, dialogue remains possible. It also called for protection of human and family rights, decried unjust discrimination, and noted points of unity among people of divergent perspectives on gender ideology.

“For instance, educational programs on this area often share a laudable desire to combat all expressions of unjust discrimination, a requirement that can be shared by all sides,” the document said.

“Indeed, it cannot be denied that through the centuries forms of unjust discrimination have been a sad fact of history and have also had an influence within the Church. This has brought a certain rigid status quo, delaying the necessary and progressive inculturation of the truth of Jesus’ proclamation of the equal dignity of men and women, and has provoked accusations of a sort of masculinist mentality, veiled to a greater or lesser degree by religious motives.”

The aim of the Church at the institutional and individual level must be the education of children in line with authentic principles which defend and instil authentic human dignity, the Congregation explains.

“In practice, the advocacy for the different identities often presents them as being of completely equal value compared to each other.”

“The generic concept of ‘non-discrimination’ often hides an ideology that denies the difference as well as natural reciprocity that exists between men and women.”

Referencing classical philosophy, historic Church teaching, Vatican Council II and the writings of several popes, the document explains the Church’s understanding of a Christian anthropology, insisting that it be at the heart of human formation.

For Christians working in schools, both religious and secular, the radical individualism of gender theory should be avoided in favor of teaching children “to overcome their individualism and discover, in the light of faith, their specific vocation to live responsibly in a community.”

Above all, the document says, the family remains “the primary community” to which the students belong and the fundamental vehicle for preserving, understanding, and transmitting human dignity.

“The school must respect the family’s culture. It must listen carefully to the needs that it finds and the expectations that are directed towards it.”

In the modern context, however, the essential alliance between school and family “has entered into crisis,” the Congregation notes.

“There is an urgent need to promote a new alliance that is genuine and not simply at the level of bureaucracy, a shared project that can offer a ‘positive and prudent sexual education’ that can harmonise the primary responsibility of parents with the work of teachers.”

“Although ideologically-driven approaches to the delicate questions around gender proclaim their respect for diversity, they actually run the risk of viewing such difference as static realities and end up leaving them isolated and disconnected from each other,” the document concludes.

Promoting a culture of dialogue between the Church and those advancing gender theory principles must take place, the document says, in a manner that respects “the legitimate aspirations of Catholic schools to maintain their own vision of human sexuality,” based on “an integral anthropology capable of harmonizing the human person’s physical, psychic and spiritual identity.”

The congregation ends by insisting on the rights of the Church, the family, and of Catholic educators to defend authentic teaching and understanding in the face of an increasingly exclusivist approach to education in line with secular progressive principles.

“A democratic state cannot reduce the range of education on offer to a single school of thought, all the more so in relation to this extremely delicate subject, which is concerned on the one hand with the fundamentals of human nature, and on the other with natural rights of parents to freely choose any educational model that accords with the dignity of the human person.”

Is the campaign for euthanasia a byproduct of neoliberalism?

h/t Bioedge

Debates about the ethics of euthanasia often centre on the issue of patient autonomy. One common argument made by proponents of legalised euthanasia is that patients should have the right to choose when and how they die, particularly when they are terminally ill and suffering intolerably.

Yet perhaps there more to the euthanasia debate than just individual autonomy. A new article in ABC Religion and Ethics presents a novel socio-economic critique of euthanasia rhetoric, analysing the global campaign for assisted dying from the perspective of contemporary economic theory.

St Vincent’s Health Australia ethicist Daniel Fleming argues that the push to legalise euthanasia is symptomatic of an ideology known as neo-liberalism. While the precise meaning of the term is debated, neo-liberalism is usually used to denote an approach to economic and social policy -- popular in the late 20th Century -- that seeks to profoundly augment consumer choice and market freedom. It has been criticised for reducing the human person to a self-regulating economic actor with no connection to community or history.

Fleming argues that this mentality is reflected in the way in which people use terms like ‘compassion’ in the euthanasia debate. Compassion, in the context of arguments for euthanasia, is really just a byword for a desire to augment the autonomy of individuals at the end of life -- as if the way in which we die were just one more market choice. Fleming writes,

“...According to [the neoliberal narrative], physical suffering is less a concern than the suffering incurred by the dependency that fragility and illness entails, and its consequent loss of autonomy, self-regulation and self-surveillance. To be compassionate according to the neoliberal narrative is to suffer with these particular concerns. The commitment following such suffering with is to open up hitherto unavailable options for the exercise of autonomy in order to reinstate what has been lost, even to the extent of that ultimate expression of individual choice: to end one's life.”

Fleming analyses assisted suicide statistics from Oregon, and comes up with some interesting conclusions. It appears that the quintessential neoliberal actor -- a white, well-educated male -- is exceedingly more likely to request euthanasia than a member of a minority group:  

“...on balance white people are over 35 times more likely to access this option at the end of their lives compared to the African American population…[those with a university] degree or higher...are 36 per cent more likely to access VAD than the rest of the population”.

It’s a long article, but well worth the read. 

Assisted dying: Doctors' group adopts neutral position

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Hospital doctors have dropped their 13-year opposition to the concept of helping terminally ill patients die.

Following a poll of its members, the Royal College of Physicians has now adopted a neutral stance on the issue of assisted dying.

Some groups have spoken out against the change, saying a respected medical body's reputation has been damaged. Others called the decision "absurd".

Under UK law, it is illegal to encourage or assist a suicide.

Nearly 7,000 doctors voted in the online poll:

• 43% thought the college should oppose a change in the law
• 32% wanted the college to support a change
• 25% were neutral

And the college has shifted to a neutral stance because neither side achieved a majority of 60%.

However, a group of doctors opposed to any change in the college's position are planning to challenge the decision to ask for a majority result.

Royal College of Physicians (RCP) president Prof Andrew Goddard said: "It is clear that there is a range of views on assisted dying in medicine, just as there is in society.

"We have been open from the start of this process that adopting a neutral position will mean that we can reflect the differing opinions among our membership.

"Neutral means the RCP neither supports nor opposes a change in the law and we won't be focusing on assisted dying in our work.

"Instead, we will continue championing high-quality palliative care services."

'Absurd decision'

Dr Gordon Macdonald, chief executive of Care Not Killing, said most doctors didn't want a change in the law on assisted suicide or euthanasia.

"We hope that the RCP will listen to this message from their members and reverse their absurd decision to adopt a position that is the least popular and commands the support of just one in four of doctors," he said.

"This is why our view is clear, society should be doing everything in our power to prevent suicide, not assist it."

Campaign group Living and Dying Well said the shift had damaged the college's reputation as a professional body.

Analysis by Fergus Walsh, BBC medical correspondent

This shift by the Royal College of Physicians has no effect on the law and does not bring assisted dying any closer.

But it is symbolic that a respected body should change its stance and has been warmly welcomed by campaigners aiming to change the law.

The decision has infuriated and dismayed those opposed to the change, however, who argue that it is unreasonable to demand a supermajority in order to maintain the status quo.

The RCP has revealed that only one of the 39 specialisms it represents met the 60% threshold.

Of palliative medicine doctors, 80% voted to maintain the college's opposition to assisted dying.

This is a group who will spend more time than any other with patients at the end of life, so their view is significant.

The RCP also pointed out that it had adopted a neutral position until 2006 and so this move was a return to its previous stance.

The BMA, the doctors' trade union, is opposed to assisted dying. Motions calling for it to adopt a neutral position have been repeatedly rejected.

Dr John Chisholm, BMA medical ethics committee chair, said: "Our focus remains on improving the standard of palliative care available for patients, through calling for greater investment and support to enable staff to deliver the highest quality end-of-life care."

From the BBC news website

Back to the source: the Hippocratic Oath re-examined

Over the centuries the Hippocratic Oath has expressed the ideals of the medical profession, although nowadays other versions have supplanted it for graduating medical students– if they take any oath at all. If taken literally the Oath is an anachronism. Who today “swears by Apollo Physician, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses”?

But T. A. Cavanaugh, a philosopher at the University of San Francisco, argues in his recent book Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession that the Oath is still relevant in establishing the fundamental ethics of the medical profession—to help and not to harm the sick.

Steeped in Hellenic culture and philosophy, Cavanaugh argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession.

Medicine as a profession, Cavanaugh contends, necessarily involves declaring the good one seeks and the bad one seeks to avoid on behalf of the sick. The idea of taking an oath implies that doctors set boundaries around what they are permitted to do. Medicine must reject the view that it is purely a technique lacking its own unique internal ethic.

h/t Bioedge

The 70th miracle: Lourdes healing officially declared supernatural

18

Lourdes, France, Feb 12, 2018 / 02:00 pm (CNA/EWTN News)

A miracle was officially recognized at the Marian shrine of Our Lady of Lourdes in France, the 70th Lourdes miracle recognized by the Catholic Church.

The miracle was officially declared by Bishop Jacques Benoit-Gonin of Beauvais, France on Feb. 11, the World Day of the Sick and the feast day of Our Lady of Lourdes. During Mass at the shrine’s basilica, Bishop Nicolas Brouwet of Lourdes announced the miracle.

The miraculous event involved a French nun, Sister Bernadette Moriau, who went on a pilgrimage to the shrine of Our Lady of Lourdes in 2008. She had been suffering from spinal complications which had rendered her wheelchair-bound and fully disabled since 1980. She also said she had been taking morphine to control the pain.

When Sister Moriau visited the Lourdes Shrine almost a decade ago, she said she “never asked for a miracle,” according to the Associated Press.

However, after attending a blessing for the sick at the shrine, something began to change.

“I felt a [surge of] well-being throughout my body, a relaxation, warmth…I returned to my room and there, a voice told me to ‘take off your braces,’” recalled the now 79-year old nun.

“Surprise. I could move,” Moriau said, noting that she instantaneously walked away from her wheelchair, braces, and pain medications.

Moriau’s case was brought to the attention of the International Medical Committee of Lourdes, who extensively researched the nun’s recovery. They eventually found that Moriau’s healing could not be scientifically explained.

After a healing is recognized by the Lourdes committee, the paperwork is then sent to the diocese of origin, where the local bishop has the final say. After the bishop’s blessing, a healing can then be officially recognized by the Church as a miracle.

The shrine of Our Lady of Lourdes in southern France is a popular pilgrimage destination for individuals with special devotions to Mary and for those seeking miraculous healings. It is the site where young Bernadette Soubirous witnessed Marian apparitions, beginning on Feb. 11, 1858. The shrine also holds a spring of water which is said to have miraculous healing properties.

While there have been more than 7,000 miraculous recoveries attributed to the intercession of Our Lady of Lourdes at the French shrine, only 70 cases have been officially recognized by the Catholic Church. A miraculous recovery must generally be a complete, spontaneous, and immediate healing from a documented medical condition.

The last official miracle attributed to the intercession of Our Lady of Lourdes was declared in 2013.

Organ donation euthanasia is gaining traction

h/t to Bioedge

You should be able to read both Kantian and Utilitarian ideas being articulated. Whilst you need to refer to Natural Moral Law and Situation Ethics in your exam this could be a useful read.

by Xavier Symons | 2 Feb 2019 |

The idea of organ donation euthanasia (ODE) is slowly garnering support in academic bioethics. In 2012, Oxford bioethicists Dominic Wilkinson and Julian Savulescu argued that chronic organ shortages provided good utilitarian justification for permitting ODE. More recently, Harvard bioethicist Robert Truog and two doctors from Western University argued in the New England Journal of Medicine that Canadian euthanasia legislation should be amended to allow for ODE.

Now a group of transplant surgeons have written an article defending ODE in one of the world’s leading transplantation journals, The Journal of Heart and Lung Transplantation.

The authors -- several doctors and ethicists from universities and hospitals in the Benelux region -- discuss both the ethics and legality of ODE. They focus in particular on Belgium and the Netherlands, where euthanasia has been legal for several years.

Currently ODE is not explicitly legal in either of these countries, though the authors suggest that there may be potential loopholes in the law.

While ODE may violate the dead donor rule, the authors argue that it is still compatible with respect for persons:

"...it is our belief that a physician should always inform a patient who is medically suitable about the possibility of organ donation, even if this could disrupt the trust relationship, as many patients may choose not to ask about donation because they assume it is not possible in this context”. 

They authors claim that organ donation euthanasia does not amount to an instrumentalisation of patients:

“[One] ethical objection to living donation and euthanasia is that people are instrumentalized to obtain organs; people could be pressured to undergo euthanasia in order to donate, whereas the public may believe euthanasia was only granted to make organ donation possible. The topic of organ donation is therefore only to be discussed after a positive decision on euthanasia has been made". 

The authors also suggest that the benefits of ODE -- in terms of lives saved -- may potentially outweigh any negative impacts that the procedure may have on public trust.

Bioethicist Wesley Smith said the article was a confirmation of his concerns about a ‘euthanasia slippery slope’. In a blog post, he warned against accepting ODE:

"May the public never be ready to accept doctors’ taking a living patient — who may not even be physically ill — into a surgical suite, anesthetizing him, and then harvesting his beating heart".