V Belgicku sa množia prípady transplantácie orgánov od pacientov – darcov, ktorí zomreli formou eutanázie | Medicínske právo
              

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V Belgicku sa množia prípady transplantácie orgánov od pacientov – darcov, ktorí zomreli formou eutanázie


 | 29.10.2012 | komentárov: 456

V Belgicku pribúda čoraz viac prípadov transplantácie orgánov od pacientov – darcov, ktorí zomreli formou aktívnej eutanázie.

Obrazok Podľa oficiálnych vyhlásení bolo v Belgicku vykonaných doposiaľ deväť takýchto transplantácií. Pred rokom oznámil tím špecialistov z nemocnice v Leuvene, že v období rokov 2007 až 2009 vykonal štyri úspešné transplantácie pľúc od eutanázovaných pacientov. V nasledujúcich troch rokoch sa objavilo ďalších päť prípadov. Uvedený typ transplantácie bol zatiaľ vykonaný okrem Belgicka iba v susednom Holandsku.

Okrem „tradičných“ sporných otázok súvisiacich s eutanáziou nadobúda v danej problematike relevanciu aj ďalšia skutočnosť, a síce, že iba nízke percento eutanázovaných pacientov je skutočne schopné darovať orgány. Väčšinu žiadateľov o eutanáziu totiž predstavujú pacienti trpiaci rakovinou. Potenciálnych darcov však možno nájsť skôr medzi pacientmi trpiacimi chorobami spojenými so svalovými alebo neurologickými poruchami, ktorí požiadajú o eutanáziu.

Doterajšia prax v tejto oblasti dôrazne vyžaduje, aby bol proces transplantácie orgánov od procesu eutanázie pacienta po právnej aj faktickej stránke striktne oddelený. To potvrdzuje nasledujúci prípad:

44-ročná pacientka trpiaca syndrómom uzamknutia sa po štyroch rokoch života s touto diagnózou rozhodla ukončiť svoj život prostredníctvom asistovanej samovraždy. Pacientka bola v súlade s belgickým právnym poriadkom vyšetrená psychiatrom a neuropsychológom, ktorí u pacientky vylúčili prítomnosť depresie a potvrdili jej mentálnu spôsobilosť na poskytnutie kompetentného súhlasu s asistovanou samovraždou. Taktiež nezávislý odborník pre oblasť paliatívnej liečby skonštatoval, že neexistuje reálna pravdepodobnosť zlepšenia zdravotného stavu pacientky. Belgická právna úprava ďalej vyžaduje, aby medzi žiadosťou o eutanáziu a samotnou eutanáziou uplynul aspoň jeden mesiac. Deň pred samotnou eutanáziou pacientka vyjadrila svoju vôľu darovať po smrti svoje orgány. Právna a etická možnosť kombinácie separovaných procesov eutanázie a darovania orgánov bola následne posúdená a odsúhlasená prezidentom etickej komisie. Proces eutanázie prebehol štandardným spôsobom: pacientka ležala v prítomnosti svojho manžela na svojej nemocničnej posteli v izbe priľahlej k operačnej sále. V miestnosti nebol prítomný nikto z transplantačného tímu. Po tom, ako bola troma nezávislými odborníkmi skonštatovaná smrť pacientky, bolo jej telo premiestnené na operačnú sálu. Následne došlo podľa štandardných alokačných pravidiel Eurotransplantu k odobratiu pečene a oboch obličiek pacientky.

Zástancovia transplantácie orgánov eutanázovaných pacientov argumentujú tým, že umožnenie tohto druhu transplantácií povedie v budúcnosti k celkovému zvýšeniu počtu transplantácií orgánov a na druhej strane poskytne určité zadosťučinenie darcovi a jeho rodine, nakoľko dobrovoľné ukončenie jeho života môže pomôcť zachrániť iný život.

Tím zdravotníckych pracovníkov, ktorí sa podieľali na uvedených transplantáciách eutanázovaných pacientov, ako aj príslušná etická komisia, vyslovili názor, že vôli pacienta darovať svoje orgány po vykonaní eutanázie by sa nemalo brániť. Transplantačný potenciál týchto pacientov v Belgicku (a Holandsku) totiž nie je zanedbateľný. Podľa oficiálnych štatistík sa počet pacientov, ktorí požiadali o eutanázu a súčasne predstavovali vhodných darcov, pohyboval medzi 5-9,5 percent z celkového počtu eutanázovaných pacientov v rokoch 2003-2005.    

AUTOR: Milan Suchý
FOTO: multiple-sclerosis-research.blogspot.com

ZDROJE
http://www.coma.ulg.ac.be/papers/LIS/Transplant_int08.pdf
http://www.bioedge.org/index.php/bioethics/bioethics_article/10257#comments
http://www.coma.ulg.ac.be/papers/death/organ_euthanasia09.pdf




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