“How’s your headache, Mr Jones?”

“Gettin’ worse, doc. Had it off and on all week.”

“That’s what we expected. Good thing you came in last week for the organ scan I recommended. Let’s look at the chart. Well, we know your heart is strong. Best ticker I’ve seen in ages. Heart like that, man your age, would go for a least half a million. I’m surprised, too, because you indicated that you’re a moderate drinker. Your LFT corroborates this—”

“—LFT?”

“Liver function test. Looks at blood levels of ALP, albumin, things like that. Shows how well the liver is working. You’re nowhere near the worst end of the scale, but you’re not the best, either. Couldn’t get more than, oh, five grand; ten tops.”

“How ’bout my stomach? I can eat anything.”

“Yes, it’s a good one. Unfortunately, we don’t really do stomach transplants. Not yet, anyway. Most people don’t know it, but you can actually live quite a productive life without a stomach. I’m not saying there’s not some value for lab work. Don’t forget, Mr Jones, we’ll use every part we can. The contract guarantees you’ll be compensated at the full wholesale rate for every organ that sells. Plus, since we caught the brain cancer early — before it spread, I mean — there’s that ten-percent bonus we discussed.”

“And you’re absolutely sure there’s nothing we can do? You can’t cut it out? Chemotherapy, maybe?”

“As we discussed, surgery might work. It might not. There’s no way to tell without actually trying. And — I don’t want to frighten you, Mr Jones — if it doesn’t work, and even sometimes when it does work, there could be suffering. You’d want to avoid suffering, wouldn’t you?”

“I guess so, doc. And my wife could sure use the money. That second mortgage is killing me. Huh. Killing me. Get it?”

“A sense of humor is very important, Mr Jones. It helps. So what’s the decision?”

The Ethics of Cannibalizing a Patient for Parts

If you get sick, dear reader, whatever you do, don’t go to the doctor. At least not in Belgium or the Netherlands, where conversations like the above might not become unusual. At least, not if some thinkers get their way.

Jan Bollen, Rankie ten Hoopen, and three others have written an article in the Journal of Medical Ethics called “Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands,” in which the prospects of harvesting organs from the bodies of those killed by “doctors” are discussed in warm terms.

“Doctors” killing patients is of course the definition of euthanasia. (Suicide does not require a medical professional.) The scare quotes are necessary to remind us that the traditional role of the physician was healing. Increasingly that old meaning is being replaced by a utilitarian concept where not life but “maximum health” is the goal of medicine. Thus, once maximum health is imperiled, some “doctors” suggest euthanasia as a “cure.”

Anyway, doctors killing patients (euthanasia) is not uncommon in portions of Europe. Once the killing is done, the patient’s body must, of course, be disposed of. Why do this wastefully? Why not put its parts to good use to maximize the health of others?

According to Bollen, in Belgium there is “presumed consent” for organ donation. Meaning they’re going after your spleen unless you specifically forbid it. In the Netherlands, patients still have to volunteer their useful parts.

The authors note that most who choose to be killed by doctors prefer to be killed at home. Bollen notes the inconvenience this poses:

When combining organ donation and euthanasia, the patient needs to be hospitalized when the physician administers the euthanasia drugs, facilitating optimal organ recovery and optimizing transplantation success of these organs.

This is why the “patient’s relatives are informed that they should say goodbye to their beloved person before” the beloved person is conked on the head.

Now the authors are aware of the obvious ethical tension. If patients know doctors are lusting after their livers, this could

cause a breach of trust with the treating physician, and one might get the impression that the physician is only willing to perform euthanasia because the patient will donate organs.

The way out of this, they say, is for doctors to “consult the Donor Registry” and “discuss the matter with the patient.” Presumably, showing a patient that somebody craves a six-foot chunk of his colon would encourage him to regain his trust in the doctor.

Just like washing a piece of fruit before eating it, prepping the still-live body is important if one is to have the freshest organs. Luckily, injectable chemicals for this exist. And they’re allowed, but only if they “not ‘harm’ the patient,” which is an odd sentiment when the patient is about to have his throat cut. (No, I’m kidding. They kill him in other ways.)

Dutch Law on Organ Donation provides the possibility to examine a potential donor and the quality of his organs, when it is certain that the patient will die within a so-called ‘limited period of time.’ As long as these examinations do not interfere with the medical treatment of the patient, physicians can prepare and perform measures that are deemed necessary to prepare for transplantation.

As the dialog above stresses, a “patient might be motivated to request euthanasia because this gives him the opportunity to donate organs.” This is not troubling so “long as all due diligence requirements are fulfilled.” The authors do note that publicity might prove problematic. So scratch those in-hospital screenings of Soylent Green. Or Monty Python’s The Meaning of Life.

What is fascinating is that Bollen et al. never mention payment. Somebody is getting money for the organs. Whom?