Dr. Christine Toevs, a trauma surgeon and ICU specialist, points to current ideas in transplantation as the fruits of Singer’s utilitarian idea. One trend seeks to optimize organ health through medications and procedures before a donor’s death, even if the intended benefit is for the organs and not for the patient to whom they still belong. Toevs asks where that slippery slope ends, but it’s a rhetorical question: A 2016 proposal by the United Network for Organ Sharing explores what it delicately terms “imminent death donation.”
Imminent death donation does not automatically mean surgical euthanasia, but that’s one idea envisioned even by its advocates: If our culture will now countenance euthanasia, why not voluntarily recycle oneself? Opponents fear that what’s currently imagined as a final act of self-sacrifice will become an expected norm, with patients who refuse being seen as selfish—or with administrators simply overriding their wishes.
We’ve seen administrators calling life-and-death shots in England. As Toevs points out, seeing people as commodities—as walking collections of usable organs—would ensure that it also happens here. As we consider how to allocate limited resources, let’s keep that old dictum in mind: First, do no harm.