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J Med Ethics doi:10.1136/medethics-2015-102898
  • Current controversy

Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands

  1. Ernst van Heurn7
  1. 1Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
  2. 2Department of Intensive Care, Maastricht University Medical Center, Maastricht, The Netherlands
  3. 3Department of Law, Maastricht University, Maastricht, The Netherlands
  4. 4Department of Hepatobiliary, Transplantation and Endocrine Surgery, Antwerp University Hospital, Antwerp, Belgium
  5. 5Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium
  6. 6Department of Intensive Care, Coordinating Intensivist for Donation Affairs, Maastricht University Medical Center, Maastricht, The Netherlands
  7. 7Department of Pediatric Surgery, Academic Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Jan Bollen, Department of Intensive Care, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; jan{at}janbollen.be
  • Received 13 May 2015
  • Revised 15 February 2016
  • Accepted 3 March 2016
  • Published Online First 24 March 2016

Abstract

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.