For professionals
Practical points of attention for physicians, nurses, organ donation coordinators and operating teams. This page is primarily based on the Dutch procedure and regulations; the medical content also matches the Belgian procedure.
Official guideline and protocols
This page focuses primarily on the Dutch procedure and regulations. The medical and logistical principles also apply to the Belgian procedure, but the legal steps and due-care criteria may differ per country. For the most current protocols, quality criteria and scientific basis, consult the Donation after euthanasia guideline of the Dutch Transplant Foundation.
Visit transplantatiestichting.nl/protocollen/donatie-na-euthanasieGuideline and framework
- Follow the multidisciplinary Organ Donation after Euthanasia (ODE) guideline of the Dutch Transplant Foundation.
- The euthanasia assessment and the donation pathway remain strictly separate decision-making tracks. The donation question must not influence the euthanasia request.
- For euthanasia on the grounds of psychiatric suffering, additional due-care requirements apply: besides the usual assessment, consultation of an independent psychiatrist is indicated, with extra attention to decision-making capacity, hopelessness and treatment alternatives. Follow the NVvP guideline on euthanasia for patients with a psychiatric disorder for this, in addition to the Donation after euthanasia guideline.
- The euthanasia is performed by the patient's own treating physician, not by the donation team.
- Legal agreements are made between the performing physician and the hospital where the procedure takes place, for example about liability and the division of tasks and responsibilities.
- Report the death as a non-natural death to the forensic physician; retrieval only starts after release by the public prosecutor.
Ethical considerations
Organ donation after euthanasia raises legitimate questions. The overview below summarises the main arguments found in the literature and public debate, both supportive and critical.
Arguments in favour
- It respects patient autonomy: someone who has already chosen euthanasia may give that choice their own meaning.
- For some patients and relatives, donation lends value and comfort to a difficult farewell.
- Organ quality is often good, because the moment is planned and warm ischaemia time stays short.
- Without this pathway, this organ and tissue potential would be lost entirely.
Critical considerations
- Risk of perceived pressure: patients must never feel steered towards euthanasia or donation. Hence the initiative must always come from the patient.
- Medicalisation of the farewell: dying in hospital rather than at home is a serious objection for some.
- Conflict of interest: decision-making on euthanasia and on donation must stay strictly separate, with different physicians.
- Conscientious objection by healthcare staff deserves room; participation is voluntary for everyone.
- Some institutions choose not to offer the procedure; that is a legitimate choice that should be communicated transparently.
Increasing the number of transplants is explicitly not the aim of this procedure. The aim is to honour the patient's explicit wish within careful medical and legal frameworks.
This page is a summary for orientation. Always consult the current national guideline and the protocols of your own institution.