Transplantation Ethics

by Robert M. Veatch

Overview

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.

Product Details

ISBN-13:	9780878408122
Publisher:	Georgetown University Press
Publication date:	01/04/2002
Edition description:	Reprint
Pages:	448
Product dimensions:	7.00(w) x 10.00(h) x 10.00(d)
Age Range:	18 Years

About 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.

Table of Contents

Preface

1. Introduction: Religious and Cultural Perspective

2. An Ethical Framework: General Theories of Ethics

Part One: Defining Death

3. The Dead Donor Rule and the Concept of Death

4. The Whole-Brain Concept of Death

5. The Circulatory, or Somatic, Concept of Death

6. The Higher-Brain Concept of Death

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

8. Crafting a New Definition-of-Death Law

Part Two: Procuring Organs

9. The Donation Model

10. Routine Salvaging and Presumed Consent

11. Markets for Organs

12. Live-Donor Transplants

13. High-Risk Donors

14. Xenotransplants: Using Organs from Animals

15. The Media's Impact on Transplants and Directed Donation

Part Three: Allocating Organs

16. The Roles of the Clinician and the Public

17. A General Moral Theory of Organ Allocation

18. Voluntary Risks and Allocations: Does the Alcoholic Deserve a New Liver?

19. Multi-Organ, Split-Organ, and Repeat Transplants

20. The Role of Age in Allocation

21. The Role of Status: The Case of Mickey Mantle, Robert Casey, Steve Jobs, and Dick Cheney

22. Geography and Other Causes of Allocation Disparities

23. Socially Directed Donation: Restricting Donation by Social Group

24. Elective Organ Transplantation

25. Vascularized Composite Allografts: Hand, Face, and Uterine Transplants

Index

What People are Saying About This

Jimmy A. Light

A comprehensive, knowledgable and thoughtful treatise on the critical ethical issues those of us in the transplant field wrestle with each day. Nice job!

James F. Childress

Without question, the best and most important book on this topic.

From the Publisher

"Without question, the best and most important book on this topic."—James F. Childress, University of Virginia

"A comprehensive, knowledgable and thoughtful treatise on the critical ethical issues those of us in the transplant field wrestle with each day. Nice job!"—Jimmy A. Light, MD, Director of Transplantation Services, Washington Hospital Center

Editorial Reviews

The book on transplantation ethics.

Choice

A comprehensive, knowledgable and thoughtful treatise on the critical ethical issues those of us in the transplant field wrestle with each day. Nice job!

Jimmy A. Light

Without question, the best and most important book on this topic.

James F. Childress

"The book on transplantation ethics."—Choice

From the Publisher

4 Stars! from Doody

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 (booknews.com)

Booknews

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 of brain death definitions. I prefer to draw my own conclusions concerning issues, but the author offering his own solutions is acceptable.

Doody's Review Service