Transplantation Ethics

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Three decades after the first heart transplant surgery stunned the world, organs, including eyes, lungs, livers, kidneys, and hearts, are transplanted every day. But despite its increasingly routine nature--or perhaps because of it--transplantation offers enormous ethical challenges. A medical ethicist who has been involved in the organ transplant debate for many years, Robert M. Veatch explores a variety of questions that continue to vex the transplantation community, offering his own solutions in many cases. Ranging from the most fundamental questions to recently emerging issues, "Transplantation Ethics" is the first complete and systematic account of the ethical and policy controversies surrounding organ transplants.

Veatch structures his discussion around three major topics: the definition of death, the procurement of organs, and the allocation of organs. He lobbies for an allocation system--administered by nonphysicians--that considers both efficiency and equity, that takes into consideration the patient's age and previous transplant history, and that operates on a national rather than a regional level.

Rich with case studies and written in an accessible style, this comprehensive reference is intended for a broad cross-section of people interested in the ethics of transplantation from either the medical or public policy perspective: patients and their relatives, transplantation professionals, other health care professionals and administrators, social workers, members of organ procurement organizations, and government officials involved in the regulation of transplants.

The book contains black-and-white illustrations.

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Editorial Reviews

From The Critics
Reviewer:Gene Edward Ridolfi, RN, BA(Washington University School of Medicine)
Description:This book is designed to provoke thought and challenge one's historical views of defining death, procuring organs, and the allocation of organs for transplantation. The initial review of the major religious and cultural views on transplantation is unique, allowing readers to reset their historical, cultural stances on death and organ procurement.
Purpose:The purpose is to provide a broad and systematic overview of transplantation ethics. This is a worthy goal, as there is always value in the evaluation and reconsideration of defining brain death and organ procurement and in a fair allocation model.
Audience:This book will be of most value to transplant professionals including physicians, nurses, psychologists, social workers, professionals in organ procurement organizations, clergy, bioethics students, hospital ethics program professionals, and public policy professionals.
Features:It begins with an overview of the major religious and cultural positions on organ donation, transplantation, and allocation. The following chapters set out to establish the multiple possibilities of defining death, at what time it is ethical to procure organs, and the design of the fairest model of allocation. The content is organized appropriately — defining brain death before transitioning to organ procurement and allocation.
Assessment:The book was of great value in helping educate me on my religious and cultural positions, dispelling some myths. It also served value in providing history and case specifics in the development ofbrain death definitions. I prefer to draw my own conclusions concerning issues, but the author offering his own solutions is acceptable.
Despite, or perhaps because of, the increasingly routine nature of organ transplant surgery, says Veath (medical ethics, Georgetown U.), it offers enormous ethical challenges. He explores a variety of questions pivoting on the definition of death, the procurement of organs, and the allocation of organs. He advocates an allocation system administered by non-physicians that considers both efficiency and equity, takes into account the patient's age and previous transplant history, and operates on a national rather than regional level. Annotation c. Book News, Inc., Portland, OR (

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780878408122
  • Publisher: Georgetown University Press
  • Publication date: 10/11/2000
  • Edition description: Reprint
  • Pages: 448
  • Sales rank: 1,375,095
  • Product dimensions: 0.91 (w) x 7.00 (h) x 10.00 (d)

Meet the Author

Robert M. Veatch is professor of medical ethics at Georgetown University's Kennedy Institute of Ethics. He has served on the board of the Washington Regional Transplant Consortium since 1988 and on the United Network for Organ Sharing's Ethics Committee from 1989 to 1995, experience that has exposed him to cutting-edge debate on moral and policy issues as they emerge on the national scene. Veatch's books include Source Book in Bioethics, edited with Albert R. Jonsen and LeRoy Walters (Georgetown University Press, 1998), which was named an Outstanding Academic Book by Choice magazine.

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Table of Contents


1. Introduction: Religious and Cultural Perspectives on Organ Transplantation

2. An Ethical Framework

Part One: Defining Death3. Brain Death: Welcome Definition or Dangerous Judgment?

4. The Definition of Death: Problems for Public Policy

5. The Whole-Brain-Oriented Concept of Death: An Outmoded Philosophical Formulation

6. The Impending Collapse of the Whole-Brain Definition of Death

7. The Conscience Clause: How Much Individual Choice Can Society Tolerate in Defining Death

8. Crafting a New Definition of Death for Public Policy Purposes

Part Two: Procuring Organs9. Gift or Salvage: The Two Models of Organ Procurement

10. The Myth of Presumed Consent: Ethical Problems in New Organ Procurement Strategies

11. Required Response: An Alternative to Presumed Consent

12. Live-Donor Transplant: Including the Premanently Unconscious and Paired- and Live-Donor/Cadaver Exchanges

13. Non-Heart Beating Cadaver Donors 14. Report of the Anencephaly Task Force of the Washington Regional Transplant Consortium

15. The Role of Age in Procurement: Minors and the Elderly as Organ Sources

16. Tainted Organs: HIV-Positive and Other Controversial Donors

17. The Ethics of Xenografts

Part Three: Allocating Organs18. Who Empowers Medical Doctors to Make Allocative Decisions for Dialysis and Organ Transplantation?

19. A General Theory of Allocation

20. Voluntary Risks and Allocation: Does the Alcoholic Deserve a New Liver?

21. Multiorgan, Split-Organ, and Repeat Transplants

22. The Role of Age in Allocation

23. The Role of Status: Did Mickey Mantle Get Special Treatment?

24. Urgency versus Geography: The Controversy between UNOS and Donna Shalala

25. Directed Donation of Organs for Transplant: Egalitarian and Maximin Approaches


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