Categorization challenges in research on organ donation after euthanasia: Determining somatic or psychiatric origins of suffering

This perspective article discusses the classification challenges encountered in organ donation after euthanasia (ODE) among individuals with psychiatric disorders, as highlighted in our recent case series. In cases involving “somatic symptoms and related disorders,” somatic symptoms are connected to excessive thoughts, feelings, and behaviors, causing distress or dysfunction. Conditions such as tinnitus and chronic pain often co-occur with psychiatric disorders. The recent Dutch guideline on ODE eliminated the requirement to distinguish between somatic and psychiatric causes of suffering. This updated guideline encourages a holistic approach to patient care, emphasizing the importance of addressing patients’ overall suffering rather than specific categorizations. To avoid errors in classification, categorization in research on ODE should recognize the overlap between somatic and psychiatric diagnoses, thereby eliminating the risk of misclassification, avoiding the stigmatization of patients, and optimizing future treatment options.