Having developed in the crucible of scarce resource allocation for nearly 60 years, the organ transplantation field has much to teach us about balancing equity with utility in the distribution of life-saving resources. Beyond the core dilemma of just allocation, organ transplantation demands that we agree on criteria for death before taking organs, decide how much risk living donors can fairly assume, identify means for increasing the supply of organs, and devise an acceptable reimbursement plan for post-transplant medical care. Contributors to this month’s issue describe ethically relevant ways to approach each of these challenging tasks.
Katrina A. Bramstedt, PhD and Francis L. Delmonico, MD
Transplant centers cannot regulate how people establish relationships, but when a donor-recipient pair comes together through Internet solicitation, the center must assess the donor’s motivations carefully.
While other organ transplants affect only the health of the recipient, reproductive tissue transplants affect the offspring of the recipient, as well as the donor and donor’s family because of their genetic relationship to the recipient’s offspring.