Response to Barker et al: The problem of living solid organ donation.

Abstract

Barker et al argue that the ultimate goal of medicine is to cure and prevent disease and, because assisted dying is not in keeping with this goal, doctors should not be required, at least in their role as doctors, to act as active agents of assisted dying. They hold that, if assisted dying is to be taken forward in England and Wales, the distinct, novel profession of 'assisted dying practitioner' should be created, the ultimate goal of which is to facilitate a good, assisted death. In their argument, the authors overlook living solid organ donation. This is an established practice in many healthcare systems, in which the living donor is neither cured of nor prevented from developing any disease and is, in fact, rendered less healthy than their predonation condition. As such, one of two possible states is true: either the authors' view of what constitutes the primary goal of medicine is correct, and the medical practice of living organ donation stands in violation of this goal; or the authors' view is incomplete, and the primary goal of medicine does not necessarily prevent doctors, in the role of doctors, from partaking as active agents of assisted dying. This article explores the ethical and practical implications of each of these possible states.