The ethics of competition in liver transplantation

Cambridge Quarterly of Healthcare Ethics

Volumn 8, Issue 3, 1999, Pages 321-329

  Thomasma, David C ^a   Micetich, Kenneth C ^a   Brems, John ^a   Van Thiel, David ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BENEFICENCE; GOVERNMENT; GOVERNMENT REGULATION; HEALTH CARE AND PUBLIC HEALTH; HEALTH CARE ORGANIZATION; HUMAN; LIVER TRANSPLANTATION; MEDICAL ETHICS; ORGANIZATION AND MANAGEMENT; PATIENT SELECTION; PROFESSIONAL MISCONDUCT; RESOURCE ALLOCATION; SOCIAL JUSTICE; STANDARD; TRANSPLANTATION; UNITED NETWORK FOR ORGAN SHARING; UNITED STATES;

HEALTH CARE AND PUBLIC HEALTH; UNITED NETWORK FOR ORGAN SHARING;

BENEFICENCE; ETHICS, MEDICAL; FEDERAL GOVERNMENT; GOVERNMENT REGULATION; HEALTH CARE RATIONING; HUMANS; LIVER TRANSPLANTATION; PATIENT SELECTION; PROFESSIONAL MISCONDUCT; RESOURCE ALLOCATION; SOCIAL JUSTICE; TISSUE AND ORGAN PROCUREMENT; TRANSPLANTS; UNITED STATES;

EID: 0033143412     PISSN: 09631801     EISSN: None     Source Type: Journal    
DOI: 10.1017/S0963180199803077     Document Type: Article

References (15)

1. How we ration and allocate health care resources. Issues: A Critical Examination of Contemporary Ethical Issues in Health Care 1996;11(60):1-8.
2. Some states challenge the federal regulations since they earlier had in place laws that regulated distribution of organs such that organs from citizens of the state were to be keep in that state. See Several states oppose organ-sharing policy. Chicago Tribune 1998;July 15.
3. Feds give transplant ultimatum: allocate organs to sickest first. Medical Ethics Advisor 1998;14(5): 49-52.
4. UNOS is a private organization contributed to by the U.S. government. Its purpose is to oversee and coordinate transplantation. It is mandated by Congress that all transplant centers belong to UNOS.
5. See Donna Shalala's initial letter to Congress.
6. Initial reaction seems to be that should a surgeon refuse to operate for organs on the ground that an individual is not in a condition that would legally permit taking organs, the regional organ bank may be able to override such decisions. See Regional Organ Bank of Illinois. Asystolic Organ Recovery Following Patient- or Family-Directed Removal of Artificial Life Support. Chicago: Regional Organ Bank of Illinois, 1997.
7. Department of Health and Human Services. Organ Procurement and Transplantation Network. Federal Register 1998;63:16296-338.
8. Associated Press. Need to be top priority with liver transplants. 26 March 1998.
9. Proposed rule on organ allocation. Excerpted in Medical Ethics Advisor 1998;14(5):52.
10. Himma KE. A critique of UNOS liver allocation policy. Cambridge Quarterly of Healthcare Ethics, this issue, pp. 311-20.
11. For example, 30% of all U.S. patients awaiting a liver transplant are on the list of 2A serious disease in Chicago, although the city itself represents only 1.5% of the U.S. population. Are we to assume that most of the liver disease in the country is concentrated here, or, alternatively, that transplant centers here are listing their patients earlier than is the national norm?
12. Note, however, that the natural history of most liver disease is not well known.
13. Is an HIV+ patient a suitable candidate for a liver transplant? Ethics Grand Rounds, Loyola University Chicago Medical Center, Maywood, Illinois, 27 October 1998.
14. HHS pushes new organ distribution. Chicago Tribune 1998;June 3:16.
15. Pellegrino ED, Thomasma DC. A Philosophical Basis of Medical Practice. New York: Oxford University Press, 1981.