Organ donation after euthanasia in children: Belgian and Dutch perspectives
Bibliographic record
Abstract
Organ donation after euthanasia has been performed more than 70 times in Belgium and the Netherlands combined (personal communication, Jan Bollen, 2018). These two countries allow for euthanasia in minors as well, while Luxembourg, Colombia and Canada only allow adults to undergo euthanasia. A Dutch guideline on organ donation after euthanasia focuses on mentally competent adults, with a predominance of neurodegenerative diseases.1 The question arises whether organ donation after euthanasia should be possible in children and adolescents, and what are the legal, medical and ethical conditions for the combined procedure. When all due diligence requirements for euthanasia have been fulfilled and no contraindications for organ donation are identified, it is possible for an adult to ask his physician to donate his organs as well. The patient undergoes several preparatory investigations to identify which organs are suitable for donation. Subsequently, euthanasia is performed by injection of a coma inducer and muscle relaxant. After 5 min ‘no touch time’ the organs are recovered in the operating room analogous to a donation after circulatory death (DCD) procedure. Lungs, liver, pancreas (islets) and kidneys can be donated and—if applicable—tissues as well. The preliminary transplantation results are promising, and organ donation after euthanasia is is thus clearly of benefit to patients awaiting transplantation.2 3 Organ donation euthanasia in children and adolescents, where the patient is anaesthetised and his organs removed in a heart-beating procedure,4 is beyond the scope of this article. In this article, the legal aspects of euthanasia and organ donation are elaborated, after which the medical and ethical dilemmas of the combined procedure are addressed, followed by a comprehensive discussion of these aspects in children and adolescents. The authors argue neither in favour of nor against euthanasia and organ donation from children; we merely aim to increase awareness regarding the possibilities and …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".