A proposal to remove donor organs from patients who are dying before they are actually dead, published today in the Dutch medical journal Medisch Contact, has met with fierce criticism.

Dutch Protestant daily Trouw reports that many doctors and the Dutch Kidney Foundation both find the idea “terrible”.

Clinical ethicist Erwin Kompanje and medical researcher Yorick de Groot of Rotterdam’s Erasmus Medical Centre have proposed removing organs from registered donors before death. They argue this would lead to a greater availability of organs “of optimum quality”. Half of all organs currently harvested are lost because of poor blood supply.

The authors of the proposal admit many doctors will intuitively reject the concept, “It is a very controversial idea, but with an eye on the chronic shortage we thought it should be talked about.”

Quality deterioration
At the moment, doctors wait for a while after terminating treatment (usually by switching off a ventilator) before rushing a donor into an operating theatre. Donor organs deteriorate quickly during this time.

The Dutch doctors’ association (KNMG Royal Dutch Medical Association) thinks it is a terrible idea. They believe a measure like this will damage the trust patients have in the medical profession.

Likewise, the Dutch Kidney Foundation says that even though 200 people die every year because there are no kidneys available, “you have to keep to your promises.” It believes the proposal gives people the wrong idea that the current rules, anchored in law, could change. The foundation says it is already receiving phone calls from worried members of the public.

Sensitive issue
The authors of the proposal are unperturbed. They say they are aware of the sensitivity surrounding the issue, and worded their proposal very carefully as a result. They say that, at best, the new proposal would be no more than an option which people could consider while they are still healthy.

Dutch newspaper AD writes that more and more kidneys are actually coming from living donors, usually family members, as fewer registered donors are dying in the 'right circumstances' for their organs to be used.