Professor of Bioethics at the University of Notre Dame Australia, Margaret Somerville has won Best Essay (Scholarly Magazines) in the Catholic Press Association United States and Canada Awards for her article ‘Does It Matter How We Die? Ethical and Legal Issues Raised by Combining Euthanasia and Organ Transplantation’.
Professor Somerville’s article was published in The Linacre Quarterly in September 2019 and explores ethical issues surrounding the combination of euthanasia and organ donation, in particular the implications of allowing euthanasia to be performed by the removal of vital organs for donation.
“I was totally surprised when I received an email from the editor of the Linacre Quarterly telling me my article had won an award,” says Professor Somerville. “First of all, I was extremely pleased to even get an article accepted in the Linacre Quarterly as the oldest continuously published journal dealing with medical ethics. The journal was founded in 1934 and at that point we didn’t have any field of scholarship or practice known as bioethics – it was, however, a journal for contemplating the kind of questions we now explore in bioethics.”
In her paper, Professor Somerville poses a series of questions: What issues does connecting euthanasia and organ donation raise? If ‘donation after death’ is practiced, why not ‘death by donation’? And why might some people who agree with euthanasia and organ donation after death by euthanasia, find death by donation ethically unacceptable? An additional issue that arises as part of this discussion is the potential impact the acceptance of ‘death by donation’ would have on important foundational societal values, especially respect for human dignity and human life.
“It’s an article that shocks a lot of people when they hear about it,” says Professor Somerville, who finds that the first reaction she gets from people upon hearing about the concept of ‘death by donation’ is usually one of disbelief. “They can’t believe the idea of euthanasia by removal of organs is an idea that’s even being considered,” she explains. “I had a similar reaction about 10 years ago, when I first heard that organs from euthanized people were being used for transplant, so I understood their reaction.”
“I have been writing and speaking about euthanasia and physician-assisted suicide for a long time; I’ve been involved in the arguments surrounding it and I’ve been a strong opponent of legalising euthanasia. In fact I think future generations will look back on it as the single most important and serious ethical decision we made as a society and as individuals in the 21st century,” says Professor Somerville.
Over time I have been told that many of the outcomes I was worried would result from legalising euthanasia simply would not happen – that euthanasia would be very rarely used, it would not be normalised, it would be very closely safeguarded so it wouldn’t be abused – but none of those reassurances have proven to be true.
Recently, an article was published in the New England Journal of Medicine, putting forward the idea that if a person had given informed consent to both euthanasia and their organs being taken after death for transplantation, then why not perform the euthanasia by giving the person a general anaesthetic and removing their vital organs. Professor Somerville decided to consider why people who agreed with euthanasia would disagree with this way of implementing it. “Even people who approve of euthanasia are shocked to hear an idea like that, but they have to ask themselves why euthanasia is ethically acceptable, but performing it in this way is not. Hence the name of my article, Does It Matter How We Die?”
Professor Somerville believes that Dr Leon Kass’s notion of the ‘wisdom of repugnance’, or the ethical ‘yuck factor’, is at play in this discussion. “We need to listen to that moral intuition,” she says. “If you’re someone who supports euthanasia and yet you have a negative reaction towards the idea of performing euthanasia by removal of organs for transplantation, then I’m challenging you to consider why that is. Ultimately, I’m trying to get people who agree with euthanasia and consider it ethical to, at the least, question their judgement in that regard.”
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