- Published in print:
- 2013
- Published Online:
- June 2013
- ISBN:
- 9780804784092
- eISBN:
- 9780804784641
- Item type:
- chapter
- Publisher:
- Stanford University Press
- DOI:
- 10.11126/stanford/9780804784092.003.0003
- Subject:
- Economics and Finance, Public and Welfare
This chapter examines the current state of the global organ procurement system and discusses the most direct consequence of the organ shortage: transplant waiting lists. It analyzes waiting list ...
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This chapter examines the current state of the global organ procurement system and discusses the most direct consequence of the organ shortage: transplant waiting lists. It analyzes waiting list dynamics and the situations both in and outside the United States. It examines the secondary effects of the shortage and analyzes the increased reliance on living donors and the rising use of marginal donors. A third “secondary consequence”—the black market for kidneys—which is considered an especially dire effect of waiting lists, is treated at some length. Finally, the chapter reviews the future prospects for the global organ shortage.Less
This chapter examines the current state of the global organ procurement system and discusses the most direct consequence of the organ shortage: transplant waiting lists. It analyzes waiting list dynamics and the situations both in and outside the United States. It examines the secondary effects of the shortage and analyzes the increased reliance on living donors and the rising use of marginal donors. A third “secondary consequence”—the black market for kidneys—which is considered an especially dire effect of waiting lists, is treated at some length. Finally, the chapter reviews the future prospects for the global organ shortage.
T. Randolph Beard, David L. Kaserman, and Rigmar Osterkamp
- Published in print:
- 2013
- Published Online:
- June 2013
- ISBN:
- 9780804784092
- eISBN:
- 9780804784641
- Item type:
- book
- Publisher:
- Stanford University Press
- DOI:
- 10.11126/stanford/9780804784092.001.0001
- Subject:
- Economics and Finance, Public and Welfare
Although organ transplants provide the best, and often the only, effective therapy for many otherwise fatal conditions, the great benefits of transplantation go largely unrealized because of failures ...
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Although organ transplants provide the best, and often the only, effective therapy for many otherwise fatal conditions, the great benefits of transplantation go largely unrealized because of failures in the organ acquisition process. In the United States, for instance, more than 10,000 people die every year either awaiting transplantation, or as a result of deteriorating health exacerbated by the shortage of organs. Issues pertaining to organ donation and transplantation represent, perhaps, the most complex and morally controversial medical dilemmas aside from abortion and euthanasia. However, these quandaries are not unsolvable. This book proposes compensating organ donors within a publicly controlled monopsony. This proposal is quite similar to current practice in Spain, where compensation for cadaveric donation now occurs “in secret,” as this text reveals. To build their recommendations, the authors provide a medical history of transplantation; a history of the development of national laws and waiting lists; a careful examination of the social costs and benefits of transplantation; a discussion of the causes of organ shortages; an evaluation of “partial” reforms tried or proposed; and an extensive ethical evaluation of the current system and its competitors.Less
Although organ transplants provide the best, and often the only, effective therapy for many otherwise fatal conditions, the great benefits of transplantation go largely unrealized because of failures in the organ acquisition process. In the United States, for instance, more than 10,000 people die every year either awaiting transplantation, or as a result of deteriorating health exacerbated by the shortage of organs. Issues pertaining to organ donation and transplantation represent, perhaps, the most complex and morally controversial medical dilemmas aside from abortion and euthanasia. However, these quandaries are not unsolvable. This book proposes compensating organ donors within a publicly controlled monopsony. This proposal is quite similar to current practice in Spain, where compensation for cadaveric donation now occurs “in secret,” as this text reveals. To build their recommendations, the authors provide a medical history of transplantation; a history of the development of national laws and waiting lists; a careful examination of the social costs and benefits of transplantation; a discussion of the causes of organ shortages; an evaluation of “partial” reforms tried or proposed; and an extensive ethical evaluation of the current system and its competitors.
- Published in print:
- 2013
- Published Online:
- June 2013
- ISBN:
- 9780804784092
- eISBN:
- 9780804784641
- Item type:
- chapter
- Publisher:
- Stanford University Press
- DOI:
- 10.11126/stanford/9780804784092.003.0005
- Subject:
- Economics and Finance, Public and Welfare
This chapter examines several primary causes of the organ shortage, beginning with the most basic economic explanation: the prohibition on compensating organ donors. For very many people, human ...
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This chapter examines several primary causes of the organ shortage, beginning with the most basic economic explanation: the prohibition on compensating organ donors. For very many people, human organs are not appropriate articles for “commerce,” and this fact has led many critics to suggest that the results of introducing compensation will not be satisfactory. Whether due to a loss of donations, public revulsion, or expansions in the waiting lists, human organs are viewed by some as very poor candidates for economic transactions. The chapter also considers several other contributing forces that appear to exacerbate the organ shortages in most countries. These include the institutional structures of organ procurement organizations, weak incentives at some intermediate stages in the transplant process, and substitution behavior among donors under uncompensated systems.Less
This chapter examines several primary causes of the organ shortage, beginning with the most basic economic explanation: the prohibition on compensating organ donors. For very many people, human organs are not appropriate articles for “commerce,” and this fact has led many critics to suggest that the results of introducing compensation will not be satisfactory. Whether due to a loss of donations, public revulsion, or expansions in the waiting lists, human organs are viewed by some as very poor candidates for economic transactions. The chapter also considers several other contributing forces that appear to exacerbate the organ shortages in most countries. These include the institutional structures of organ procurement organizations, weak incentives at some intermediate stages in the transplant process, and substitution behavior among donors under uncompensated systems.
- Published in print:
- 2013
- Published Online:
- June 2013
- ISBN:
- 9780804784092
- eISBN:
- 9780804784641
- Item type:
- chapter
- Publisher:
- Stanford University Press
- DOI:
- 10.11126/stanford/9780804784092.003.0001
- Subject:
- Economics and Finance, Public and Welfare
This introductory chapter first sets out the book's main arguments, that the problems of organ transplantation, and the shortages of organs for that purpose, are not unsolvable. The primary problems ...
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This introductory chapter first sets out the book's main arguments, that the problems of organ transplantation, and the shortages of organs for that purpose, are not unsolvable. The primary problems are not technological but are instead political and moral, and we have the means now to resolve the shortage over a reasonable period if we choose to do so. It suggests that any practical solution to the organ shortages under current technological means must involve paying meaningful compensation to donors for their willingness to donate. Compensation may be paid both to the families of deceased donors and to living donors (in the case of kidneys). It further proposes the establishment of public monopsony buyers for organs, and argues that such a system may be adequately managed to produce greatly improved patient outcomes while saving money and avoiding serious moral failings. An overview of the subsequent chapters is also presented.Less
This introductory chapter first sets out the book's main arguments, that the problems of organ transplantation, and the shortages of organs for that purpose, are not unsolvable. The primary problems are not technological but are instead political and moral, and we have the means now to resolve the shortage over a reasonable period if we choose to do so. It suggests that any practical solution to the organ shortages under current technological means must involve paying meaningful compensation to donors for their willingness to donate. Compensation may be paid both to the families of deceased donors and to living donors (in the case of kidneys). It further proposes the establishment of public monopsony buyers for organs, and argues that such a system may be adequately managed to produce greatly improved patient outcomes while saving money and avoiding serious moral failings. An overview of the subsequent chapters is also presented.
Farhat Moazam
- Published in print:
- 2014
- Published Online:
- January 2014
- ISBN:
- 9780199682676
- eISBN:
- 9780191763168
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199682676.003.0061
- Subject:
- Philosophy, Moral Philosophy
In their article, Mark Aulisio and Nicole Deming raise concern for the perils inherent in “straining” the ethically justifiable paradigm of living related organ donation. However, in emphasizing the ...
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In their article, Mark Aulisio and Nicole Deming raise concern for the perils inherent in “straining” the ethically justifiable paradigm of living related organ donation. However, in emphasizing the need for higher standards for donor informed consent as a safeguard, they frame their arguments within the dominant “Western” paradigm of individual rights and autonomous choices. This ignores the reality that organ donation decisions have complex, multifaceted cultural, religious, and socioeconomic dimensions which cannot be encompassed by philosophical principles alone. The author’s commentary, based on ethnographic research on living kidney donation in Pakistan, highlights an alternative moral world of extended kinship systems in which major decisions in life are perceived to lie in the collective domain.Less
In their article, Mark Aulisio and Nicole Deming raise concern for the perils inherent in “straining” the ethically justifiable paradigm of living related organ donation. However, in emphasizing the need for higher standards for donor informed consent as a safeguard, they frame their arguments within the dominant “Western” paradigm of individual rights and autonomous choices. This ignores the reality that organ donation decisions have complex, multifaceted cultural, religious, and socioeconomic dimensions which cannot be encompassed by philosophical principles alone. The author’s commentary, based on ethnographic research on living kidney donation in Pakistan, highlights an alternative moral world of extended kinship systems in which major decisions in life are perceived to lie in the collective domain.
