Kennedy Institute of Ethics Journal

Kennedy Institute of Ethics Journal
Volume 13, Number 1, March 2003


Contents

Articles

    Etzioni, Amitai.
  • Organ Donation: A Communitarian Approach
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    Subject Headings:
    • Donation of organs, tissues, etc. -- Moral and ethical aspects -- United States.
    • Communitarianism -- United States.
    Abstract:
      Recently, various suggestions have been made to respond to the increasingly great shortage of organs by paying for them. Because of the undesirable side effects of such approaches (commodification, injustice, and costs), a communitarian approach should be tried first. A communitarian approach to the problem of organ shortage entails changing the moral culture so that members of society will recognize that donating one's organs, once they are no longer of use to the donor, is the moral (right) thing to do. This approach requires much greater and deeper efforts than sharing information and making public service announcements. It entails a moral dialogue, in which the public is engaged, leading to a change in what people expect from one another. Among the devices that could help to change the moral culture are a public statement, endorsed by community members and leaders, that expresses the community sense that donation "is what a good person does" and a community-specific web page that lists those who have made the commitment. A change in law so that a person's wishes in the matter are recognized as final and binding is also desired. This position paper deals only with cadaver organs and not living donors.
    Veatch, Robert M.
  • Why Liberals Should Accept Financial Incentives for Organ Procurement
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    Subject Headings:
    • Procurement of organs, tissues, etc. -- Economic aspects -- United States.
    • Tax incentives -- United States.
    • Donation of organs, tissues, etc. -- Moral and ethical aspects -- United States.
    Abstract:
      Free-market libertarians have long supported incentives to increase organ procurement, but those oriented to justice traditionally have opposed them. This paper presents the reasons why those worried about justice should reconsider financial incentives and tolerate them as a lesser moral evil. After considering concerns about discrimination and coercion and setting them aside, it is suggested that the real moral concern should be manipulation of the neediest. The one offering the incentive (the government) has the resources to eliminate the basic needs that pressure the poor into a willingness to sell. It is unethically manipulative to withhold those resources and then offer payment for organs. Nevertheless, the poor have been left without basic necessities for 20 years since the passage of the prohibition on incentives. As long as the government continues to withhold a decent minimum of welfare, liberals should, with shame, cease opposing financial incentives for organ procurement.
    Bartz, Clifford Earle.
  • Operation Blue, ULTRA: DION--The Donation Inmate Organ Network
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    Subject Headings:
    • Transplantation of organs, tissues, etc. -- Law and legislation -- United States.
    • Organ donors -- United States.
    • Prisoners -- Legal status, laws, etc. -- United States.
    Abstract:
      Presently more than 80,000 Americans await an organ transplant, while 10 to12 people die each day because of the lack of organs. The program proposed here would allow federal inmates additional "time off" for agreeing to become living donors or to provide organs or their bodies upon death. Such a program could add 100 to 170 thousand new organ donors to the pool, with another 10 to 12 thousand added annually. If the program were applied to all state inmates, up to 4 million new donors might be added, with another 10 to 13 thousand added annually. Given the extreme need for more organ donors and the need for more living donors, the current National Transplant Act of 1984 and the Uniform Anatomical Gift Act must be amended, while still retaining control of donation procedures.
    Kahn, Jeffrey P.
  • Three Views of Organ Procurement Policy: Moving Ahead or Giving Up?
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    Subject Headings:
    • Etzioni, Amitai. Organ donation: a communitarian approach.
    • Veatch, Robert M. Why liberals should accept financial incentives for organ procurement.
    • Bartz, Clifford Earle. Operation blue, ULTRA: DION--the donation inmate organ network.
    • Procurement of organs, tissues, etc. -- United States.
    • Donation of organs, tissues, etc. -- Law and legislation -- United States.
    Abstract:
      The supply of organs for transplant remains inadequate to meet the needs of waiting patients, in spite of many programs and approaches to increase rates of donation. Over the years there have been numerous proposals to introduce schemes that would move toward the outright sale of organs. Three articles in this issue of the Journal propose methods for increasing organ supply—two by moving toward a market approach and the third by advocating a change in social culture. All three suffer from shortcomings, including the endorsement and encouragement of the exploitation of those who may offer organs. Although the shortage of organs must be addressed, the social price of a market in organs is too high, and proposals to encourage a rethinking of social responsibility are unlikely to be effective.

Bioethics Inside the Beltway

    Curtis, Alexander S.
  • Congress Considers Incentives for Organ Procurement
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    Subject Headings:
    • Donation of organs, tissues, etc. -- Law and legislation -- United States.
    • Tax incentives -- United States.

Scope Note 43




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