Choosing death and saving lives? Organ donation within the voluntary assisted dying process
Jackie Leach Scully1, Disability Innovation Institute, University of New South Wales Sydney 1Disability Innovation Institute, University of New South Wales, Sydney, NSW, Australia
Abstract
Transplantation is a life-changing innovation that has become thoroughly integrated into medical practice and cultural awareness. Despite technical advances it remains dependent on the availability of organs, primarily from deceased donors. As is well known, there is a chronic lack of clinically suitable and available organs. Data from the ANZ organ donation registry show that in April 2023 there were 1891 people on the transplant waiting list, some of whom are likely to die before an organ gets to them. This scarcity creates a constant pressure to increase the number of donor organs.
Voluntary assisted dying (VAD) is a much less familiar medical practice. In the recent discussion of VAD as it becomes legal in NSW and other states, the possibility of using organs donated by people using the VAD pathway has been raised. Although it would be legal under both organ donation and VAD legislation in Australia, there are clinical and practical reasons why organ donation after VAD is uncommon. Nevertheless, cases are known to have occurred in several countries (Mulder eg al 2021), and it is highly likely that some future application for post-VAD organ donation in Australia will further the debate here.
In this paper I will outline some of the most discussed ethical issues raised by organ donation after VAD, highlighting less obvious ones, including the possible effect on the public perception of healthcare that holds both organ donation and VAD as standard practices.
Biography
Jackie Leach Scully is Professor of Bioethics and Director of the Disability Innovation Institute at UNSW. With a focus on implications for marginalised groups, her research interests include feminist approaches to bioethics, disability bioethics, genetic and genomic medicine, AI and automation in healthcare, and organ donation and transplant medicine.