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Oxford Neonatologist Says Time Has Come to Consider “Mandatory Organ Donation”
Also suggests that “donor death” criteria for organ donation should be abandoned

According to Dr. Julian Savulescu, the Uehiro Chair of Practical Ethics at the University of Oxford, and neonatologist and Oxford graduate student Dominic Wilkinson, bold steps may have to be taken to increase the supply of organs for transplant. 

This, they say in a co-authored article published today, could be accomplished by removing one simple impediment – the requirement of donor "death." In a separate article, published last week, Wilkinson suggested an even more radical plan – mandatory organ donation.

"We could abandon the dead donor rule," wrote the pair in today’s article, published on Oxford’s Centre of Practical Ethics’ website. "We could for example, allow organs to be taken from people who are not brain dead, but who have suffered such severe injury that they would be permanently unconscious, like Terry Schiavo, who would be allowed to die anyway by removal of their medical treatment."

Romanian-Australian professor Savulescu's most recent statements are entirely of a piece with his outspoken advocacy of the most controversial forms of human manipulation, including genetic screening, cloning, human/plant or human/beast hybrids, and the use of performance enhancing drugs for athletes.

Savulescu, a proponent of the most radical form of utilitarian ethics, told the Sydney Morning Herald in August that when he was a young doctor he was a “believer,” until he encountered an unsettling image of death in the form of a corpse. 

"That, for me, just made the meaninglessness of death extremely vivid," he said.  "You think there's something beautiful and peaceful about death. There's not. People's mouths are sewn together." 

He then left medicine to complete a Ph.D. on "good reasons to die," reported the Herald.

Savulescu and his protégé, graduate student Dominic Wilkinson, published the article in response to the concerns raised by Australian Dr. James Tibballs that under the current “brain death” criteria, most donors will actually surrender their organs while they are still alive. (

In doing so the Oxford scholars have joined the small but influential chorus of organ donation proponents who have downplayed the doctor's statements, complaining they would stem the flow of organs from donors, who may begin to think twice about signing that donor card.

Wilkinson also published a solo article on October 20, in which he not only suggested the removal of the death criteria for organ donation, but also the criteria of consent.

One solution to the perceived dearth of donated organs, Wilkinson says, is to simply give patients the option to donate their organs before death.  Another alternative: remove the superfluous requirement of choice. "We may come to think that the benefit of organ donation is so great that we should reject the current charade of informed consent for organ donation," wrote Wilkinson. 

“After all, at present thousands of patients per year die for want of an available organ. Yet every day potentially life-saving organs are buried or burned because their owners did not make their wishes clear during life, because their families could not come to terms with the idea of donation, or because doctors failed to approach families to ask them for permission.

"Consent is relevant to what happens to us while we are alive. But once we are dead, our organs cannot benefit us, while they could save the lives of up to 6 others. Perhaps it is time to contemplate mandatory organ donation after death?" 

Wilkinson says that he agrees with Tibballs that the precise moment of death is a "fiction," and calls upon the medical community to "change the moment of death" and "move the definitional point of death slightly earlier into the dying process to account for his [Tibballs'] worries."

In the more recent article, the one co-authored with Savulescu, the authors claim that Tibballs' concern that patients are being dissected alive are irrelevant.  "Whether or not this is true," they write, "there is no dispute on one issue: organs are not being taken from people who would have lived if their organs had not been taken."

Not all agree with this statement, however.  An increasing number of doctors and bioethicists, including Tibballs, are becoming alarmed at evidence pointing to the routine evisceration of patients that might have recovered. LSN has in the past reported numerous cases in which organ donors were found to be alive only moments before dissection, often making a complete recovery.  (;

Savulescu and Wilkinson, however, also take into consideration this objection by suggesting that people who have merely "a low chance of any meaningful recovery" could still be eligible for organ removal.

Conservative bioethicist Wesley J. Smith responded to Wilkinson’s original article, saying, "I believe and hope that this remains a minority view."

"But the fact that it is considered a matter of respectable discourse is cause for concern."

To read the original articles see:

Death Fiction and Taking Organs from the Living

The Paradox of Organ Donation Consent

See related coverage:

Melbourne Doctor: Most Donors Still Alive when Organs are Removed

New England Journal of Medicine: 'Brain Death' is not Death

Doctors Who Almost Dissected Living Patient Confess Ignorance about Actual Moment of Death

Doctor Says about "Brain Dead" Man Saved from Organ Harvesting – "Brain Death is Never Really Death"

Denver Coroner Rules "Homicide" in Organ-Donor Case

Russian Surgeons Removing Organs Saying Patients Almost Dead Anyway
[24Oct08,Kathleen Gilbert,OXFORD, UK,]