Lainie Friedman Ross, MD, PhD, the Carolyn and Matthew Bucksbaum Professor of Clinical Ethics, and J. Richard Thistlethwaite, MD, Professor Emeritus, have published a new book, The Living Organ Donor as Patient: Theory and Practice, arguing that living donor organ transplantation can be ethical, provided that we treat living solid organ donors as patients in their own right.
When the first successful living kidney donor transplant took place in 1954, it was meant to be a temporary stopgap. Today, we are no closer to the goal of adequate organ supply without living donors. If anything, the supply-demand ratio is worse. While most research on the ethics of organ transplantation focuses on how to allocate organs as a scarce medical resource, the ethical treatment of organ donors themselves has been relatively neglected.
In their new book, Ross and Thistlethwaite develop a five-principle framework to examine some of the attempts to increase living donation. It uses three research ethics principles: respect for persons, beneficence, and justice modified to organ transplantation, as well as the principles of vulnerability and special relationships creating special obligations. Their approach requires that the transplant community fully embraces current and prospective living organ donors as patients to whom we have special obligations.
“Our goal,” they write, “is to explore the ethical issues raised by policies and practices proposed and/or implemented to expand living solid organ donation and transplantation to help define the moral limits of living donor organ transplantation. We argue that ethical practice requires the living donor always be treated and respected, first and foremost, as a patient.”
The Living Organ Donor as Patient: Theory and Practice is now available from Oxford University Press.
