We really can't promise both more transplants and better outcomes. The controversies over organ allocation really represent intellectual exhaustion in the face of a long series of inadequate policy responses to the decade-long trend of the kidney supply increasing only at the expense of organ quality and patient outcomes.
The pauses the transplant community has taken, at various times throughout the history of transplantation, to make sure that transplantation was truly a boon to patients represent genuine ethical engagement.
Bruce C. Vladeck, PhD, Sander Florman, MD, and Jonathan Cooper, JD
The United Network for Organ Sharing’s geographic allocation system is outdated and inequitable, particularly in light of improved ability to transport organs. Allocation should be based on common medical criteria, not accidents of geography.
The belief persists that patient satisfaction surveys are more responsive to friendliness and expensive facilities than clinician interaction, but there is evidence to the contrary.
When a patient requests an unfamiliar treatment, the physician should not hesitate to research it before giving a categorical reply about its safety or efficacy.
Nancy Berlinger, PhD and Annalise Berlinger, BSN, RN
Physicians’ reliance on “culture” to explain patients’ noncompliance may serve as code for their discomfort with difference, uncertainty, and distress.
AMA J Ethics. 2017;19(6):608-616. doi:
10.1001/journalofethics.2017.19.6.msoc1-1706.