GESTIÓN EN SALUD PÚBLICA: BioEdge: Amend law to allow organ donor euthanasia, say Canadian doctors

domingo, 16 de septiembre de 2018

BioEdge: Amend law to allow organ donor euthanasia, say Canadian doctors

BioEdge: Amend law to allow organ donor euthanasia, say Canadian doctors

Bioedge

Amend law to allow organ donor euthanasia, say Canadian doctors

by Michael Cook | 15 Sep 2018 |

Canadian legislation and medical protocols need to be tweaked to allow euthanasia with organ donation, according to an opinion piece in the New England Journal of Medicine. Two doctors from Western University, in Ontario, and Robert Truog, a Harvard Medical School bioethicist, outline the changes that will be needed to ensure that patients can give as many healthy organs as possible.

Euthanasia offers significant advantages for transplant surgeons. The normal protocol is to wait for a couple of minutes after blood circulation ceases (donation after cardiac death). But even in that brief space of time the quality of the organs declines. If they were removed in a coordinated operation from a euthanasia patient, they would be as fresh as possible.

To achieve this, a few changes need to be made. The staff of intensive care wards are trained to keep people alive; in organ donation after euthanasia they would have to kill the patient. At the moment, too, a firewall exists between withdrawal of life support and organ donation so that patients are not killed for their organs. But with legalised euthanasia, there will be no need for the firewall.

Conscientious objectors could pose an obstacle.

Hospitals and organ-procurement organizations must therefore have protocols that allow clinicians who object to opt out. Organizations also need to consider where to draw the boundaries of legitimate conscientious objection. Does the right to opt out extend to laboratory and pharmaceutical staff? What about the disposition of these organs — should clinicians be permitted to opt out of participating in the transplantation of donated organs, and should potential recipients be informed about the source of the organs in case they may want to decline transplantation?

It would also be necessary to do away with the dead donor rule – that a patient must be dead before donating. Presumably most euthanasia patients would agree to death through donation. But, at least 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.

The patients would be affected as well. One of the attractions of euthanasia is the prospect of dying peacefully surrounded by family and well-wishers. But with organ donation euthanasia patients would die in the sterile atmosphere of an operating theatre.

Sunday, September 16, 2018

Last year Sydney journalist Miranda Devine interviewed Australia’s first out-of-the-closet transsexual, Carlotta, a cabaret performer and TV actor. Carlotta had what is now called “gender-affirming” surgery in the early 1970s and built a career in show biz. Her advice to teenagers who want to transition to the opposite sex: “Don’t give the child hormones. Wait till 18. You shouldn’t fool around with the body until you’re mature.”

This seems common sense. However, as an article in JAMA Pediatrics (see below) reports, girls as young as 13 are receiving mastectomies to treat their gender dysphoria. Two years later (ie, when they’re 15) the transteens are supposedly as happy as Larry with their “top job”.

This doesn’t seem common sense. How can a girl of 13 give truly informed consent to a life-changing operation which removes both of her breasts? As a growing number of “detransitioners” bear witness, this is crazy. “I’m a real-live 22-year-old woman with a scarred chest and a broken voice and a 5 o’clock shadow because I couldn’t face the idea of growing up to be a woman,” says Carla in a YouTube video.

The risk of turning a young girl’s life into a misery is just too great to allow teen mastectomies before adulthood. In fact, it’s hard to describe it as anything other than child abuse by her physicians and psychologists. What do you think?