Organ Transplantation and Ethical Considerations

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Organ Transplantation and Ethical Considerations

In February 2003, 17-year-old Jesica Santillan received a heart-lung transplant at Duke University Hospital that went badly awry because, by mistake, doctors used donor organs from a patient with a different blood type. The botched operation and subsequent unsuccessful retransplant opened a discussion in the media, in internet chat rooms, and in ethicists' circles regarding how we, in the United States, allocate the scarce commodity of organs for transplant. How do we go about allocating a future for people who will die without a transplant? How do we go about denying it? When so many are waiting for their shot at a life worth living, is it fair to grant multiple organs or multiple transplants to a person whose chance for survival is slim to none? And though we, as compassionate human beings, want to help everyone, how far should our benevolence extend beyond our borders? Are we responsible for seeing that the needy who come to America for help receive their chance, or are we morally responsible to our own citizens only?

Rationing scarce resources presents an ethical challenge. I believe that since available organs are so scarce, it is imperative that the utility of donated organs be maximized. In this paper, I suggest that organ allocation be rooted in distributive justice, which demands that equals be treated equally and unequals be treated unequally. I will explore this formal principle and the substantive criteria of equality, need and efficacy (maximum survivability) as they relate to the just allocation of organs for transplant. I will apply these principles of justice to Jésica's case to show that while her first transplant was warranted, her second was not. And, fin...

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