Advertisement
Research Article| Volume 2, ISSUE 1, P133-148, January 1986

The Gift of Life

Ethical Problems and Policies in Obtaining and Distributing Organs for Transplantation
  • James F. Childress
    Correspondence
    Corresponding author: Department of Religious Studies, Cocke Hall, University of Virginia, Charlottesville, Virginia 22903
    Affiliations
    Commonwealth Professor of Religious Studies; and Professor of Medical Education, University of Virginia, Charlottesville, Virginia
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.
      The supply of organs and tissues is inadequate to meet the need and demand for transplantation. The article argues for an effective and efficient system for obtaining cadaveric organs that can reduce and perhaps even eliminate scarcity, without violating the principles of justice and respect for persons. The article also examines policies and problems regarding living donors, and analyzes some issues in macroallocation and microallocation.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Critical Care Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Annas G.J.
        Life, liberty, and the pursuit of organ sales.
        Hastings Cent. Rep. 1984; 14: 22-23
        • Bart K.J.
        • Macon E.J.
        • Humphries A.L.
        • et al.
        Increasing the supply of cadaveric kidneys for transplantation.
        Transplantation. 1981; 31: 383-387
        • Beauchamp T.L.
        • Childress J.F.
        Principles of Biomedical Ethics. Edition 2. Oxford University Press, New York1983
        • Bernstein D.M.
        The organ donor.
        J.A.M.A. 1977; 237: 2643-2644
        • Bernstein D.M.
        • Simmons R.G.
        The adolescent kidney donor: The right to give.
        Am. J. Psychiatry. 1974; 131: 1338-1343
        • Caplan A.L.
        Organ procurement: It’s not in the cards.
        Hastings Center Report. 1984; 14: 9-12
        • Caplan A.L.
        Organ transplants: The costs of success.
        Hastings Center Report. 1983; 12: 23-32
        • Caplan A.L.
        • Lidz C.W.
        • Meisel A.
        • et al.
        Mrs. X and the bone marrow transplant (case study and commentaries).
        Hastings Center Report. 1983; 13: 17-19
        • Childress J.F.
        Priorities in Biomedical Ethics. The Westminster Press, Philadelphia1981
        • Childress J.F.
        Who Should Decide? Paternalism in Health Care. Oxford University Press, New York1982
        • Christopherson L.K.
        Heart transplants.
        Hastings Center Report. 1982; 12: 19
      1. Council on Scientific Affairs: Organ donor recruitment.
        J.A.M.A. 1981; 246: 2157-2158
        • Denny D.
        How organs are distributed.
        Hastings Center Report. 1983; 13: 23-32
        • Dickens B.
        Control of living body materials.
        Toronto Law Rev. 1977; 27: 142
        • Dukeminier J.
        • Sanders D.
        Organ transplantation: Proposal for routine salvaging of cadaver organs.
        N. Engl. J. Med. 1968; 279: 413-419
        • Eisendrath R.M.
        • Guttmann R.D.
        • Murray J.E.
        Psychologic considerations in the selection of kidney transplant donors.
        Surg. Gynecol. Obstet. 1969; 129: 243-248
        • Englehardt H.T.
        Shattuck lecture: Allocating scarce medical resources and the availability of organ transplantation.
        N. Engl. J. Med. 1984; 311: 66-71
        • Feinberg J.
        Sentiment and sentimentality in practical ethics.
        Proc. Addresses Am. Philosoph. Assoc. 1982; 56: 19-46
        • Fellner C.H.
        • Marshall J.R.
        Kidney donors: The myth of informed consent.
        Am. J. Psychiatry. 1970; 126: 1245-1251
        • Fellner C.H.
        • Schwartz S.H.
        Altruism in disrepute: Medical versus public attitudes toward the living organ donor.
        N. Engl. J. Med. 1971; 284: 582-585
        • Fost N.
        Children as renal donors.
        N. Engl. J. Med. 1977; 296: 363-367
      2. Hearings on Organ Transplants before the Subcommittee on Investigations and Oversight of the Committee on Science and Technology, U.S. House of Representatives. U.S. Government Printing Office, Washington, D.C1983 (April 1983)
        • Hollenberg N.K.
        Altruism and coercion: Should children serve as renal donors?.
        N. Engl. J. Med. 1977; 296: 390-391
        • Iglehart J.K.
        Transplantation: The problem of limited resources.
        N. Engl. J. Med. 1983; 309: 123-128
        • Katz J.
        • Capron A.M.
        Catastrophic Diseases: Who Decides What? Russell Sage Foundation, New York1975
        • Kaufman H.H.
        • et al.
        Kidney donation: Needs and possibilities.
        Neurosurgery. 1979; 5: 237-243
        • Kennedy I.
        The donation and transplantation of kidneys: Should the law be changed?.
        J. Med. Ethics. 1979; 5: 13-21
        • Lawton R.L.
        Living nonrelated donors for transplantation.
        Proc. Dialysis Transplant Forum. 1978; : 30-34
        • Matas A.J.
        • Veith F.J.
        Presumed consent for organ retrieval.
        Theor. Med. 1984; 5: 155-166
        • Mavrodes G.I.
        The morality of selling human organs.
        in: Basson M.D. Ethics, Humanism, and Medicine. Alan R. Liss, New York1980
        • May W.F.
        Attitudes toward the newly dead.
        Hastings Center Studies. 1972; 1: 3-13
        • McCormick R.A.
        Organ transplantation: Ethical principles.
        in: Reich W.T. Encyclopedia of Bioethics. Macmillan/Free Press, New York1978
        • Muvskens J.
        An alternative policy for obtaining cadaver organs for transplantation.
        Philosophy Publ. Affairs. 1978; 8: 88-99
        • Perry C.
        Human organs and the open market.
        Ethics. 1980; 91: 63-71
        • Peters D.A.
        Marketing organs for transplantation.
        Dialysis Transpl. 1984; 13: 40-42
        • Prottas J.M.
        Encouraging altruism: Public attitudes and the marketing of organ donation.
        Milbank Mem. Fund Q. (Health and Society). 1983; 61: 278-306
        • Prottas J.M.
        Obtaining replacements: The organizational framework of organ procurement.
        J. Health Polit. Policy Law. 1983; 8: 235-250
        • Ramsey P.
        The Patient as Person. Yale University Press, New Haven1970
        • Roberts S.D.
        • Douglas R.W.
        • Gross T.L.
        Cost-effective care of end-stage renal disease: A billion dollar question.
        Ann. Intern. Med. 1980; 92: 243-248
        • Robertson J.A.
        Organ donations by incompetents and the substituted judgment doctrine.
        Columbia Law Rev. 1976; 76: 48-78
        • Sadler Jr., A.M.
        • Sadler B.L.
        A community of givers, not takers.
        Hastings Center Report. 1984; 14: 6-9
        • Sadler Jr., A.M.
        • Sadler B.L.
        • Stason E.B.
        • et al.
        Transplantation: A case for consent.
        N. Engl. J. Med. 1969; 280: 862-867
        • Sanders D.
        • Dukeminier Jr., J.
        Medical advance and legal lag: Hemodialysis and kidney transplantation.
        U.C.L.A. Law Rev. 1968; 15: 357-413
        • Scott R.
        The Body as Property. Viking Press, New York1980
        • Sells R.A.
        Let’s not opt out: Kidney donation and transplantation.
        J. Med. Ethics. 1979; 5: 165-169
        • Simmons A.J.
        Tacit consent and political obligation.
        Philosophy Publ. Affairs. 1976; 5: 274-295
        • Steinbrook R.L.
        Kidneys for transplantation.
        J. Health Polit. Policv Law. 1981; 6: 504-519
        • Steinbrook R.L.
        Unrelated volunteers as bone marrow donors.
        Hastings Center Report. 1980; 10: 11-14
        • Stuart F.P.
        • Veith F.J.
        • Cranford R.E.
        Brain death laws and patterns of consent to remove organs for transplantation from cadavers in the United States and 28 other countries.
        Transplantation. 1981; 31: 238-244
        • Titmuss R.
        The Gift Relationship. Pantheon, New York1971