Ronald Y. Nakasone
David E. Guinn (ed.)
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780195178739
- eISBN:
- 9780199784943
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195178734.003.0014
- Subject:
- Religion, Philosophy of Religion
This chapter examines the structure and role of ambiguity in the Japanese Organ Transplant Law by looking at the Chinese Huayen Buddhist doctrine of dharmadhatu-pratityasamutpada (fajie yuanqi shuo) ...
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This chapter examines the structure and role of ambiguity in the Japanese Organ Transplant Law by looking at the Chinese Huayen Buddhist doctrine of dharmadhatu-pratityasamutpada (fajie yuanqi shuo) or universal dependent “coarising”, a major interpretation of the Buddha's pratityasamutpada, dependent-coarising or interdependence. Specifically, it will examine the nature of ambiguity through the zhuban yuanming jude men or “the attribute of the complete accommodation of principal and secondary dharmas” that Fazang (643-712) formulated. The interdependent and evolving Buddhist vision of reality causes ambiguity in decision making and action.Less
This chapter examines the structure and role of ambiguity in the Japanese Organ Transplant Law by looking at the Chinese Huayen Buddhist doctrine of dharmadhatu-pratityasamutpada (fajie yuanqi shuo) or universal dependent “coarising”, a major interpretation of the Buddha's pratityasamutpada, dependent-coarising or interdependence. Specifically, it will examine the nature of ambiguity through the zhuban yuanming jude men or “the attribute of the complete accommodation of principal and secondary dharmas” that Fazang (643-712) formulated. The interdependent and evolving Buddhist vision of reality causes ambiguity in decision making and action.
William R. Clark
- Published in print:
- 2008
- Published Online:
- September 2008
- ISBN:
- 9780195336634
- eISBN:
- 9780199868568
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195336634.003.0013
- Subject:
- Biology, Disease Ecology / Epidemiology
T cells are the major barrier to the transplantation of organs between other than genetically identical twins. The basis for immune rejection lies in the incredible heterogeneity among humans in ...
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T cells are the major barrier to the transplantation of organs between other than genetically identical twins. The basis for immune rejection lies in the incredible heterogeneity among humans in histocompatibility genes and proteins. Rejection can be managed somewhat by careful histocompatibility matching of donor and recipient, and with drugs that suppress T cell function, but permanent acceptance of transplants has yet to be achieved. This chapter examines how T cells detect transplants as foreign, and the mechanisms they use to reject them. A close study of these processes may suggest better strategies for ensuring transplant survival.Less
T cells are the major barrier to the transplantation of organs between other than genetically identical twins. The basis for immune rejection lies in the incredible heterogeneity among humans in histocompatibility genes and proteins. Rejection can be managed somewhat by careful histocompatibility matching of donor and recipient, and with drugs that suppress T cell function, but permanent acceptance of transplants has yet to be achieved. This chapter examines how T cells detect transplants as foreign, and the mechanisms they use to reject them. A close study of these processes may suggest better strategies for ensuring transplant survival.
- Published in print:
- 2013
- Published Online:
- June 2013
- ISBN:
- 9780804784092
- eISBN:
- 9780804784641
- Item type:
- chapter
- Publisher:
- Stanford University Press
- DOI:
- 10.11126/stanford/9780804784092.003.0002
- Subject:
- Economics and Finance, Public and Welfare
This chapter this traces the historical paths that led to modern transplantation technology and the organ procurement policy that supports it. It discusses the genesis, advances, and constraints of ...
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This chapter this traces the historical paths that led to modern transplantation technology and the organ procurement policy that supports it. It discusses the genesis, advances, and constraints of organ transplant technology. It describes the important aspects of an organ transplant process. It outlines the types of transplants and sources of organs, and examines the patients' perspective. The chapter also considers the existing procurement system and its philosophical-ideological base: altruistic donation.Less
This chapter this traces the historical paths that led to modern transplantation technology and the organ procurement policy that supports it. It discusses the genesis, advances, and constraints of organ transplant technology. It describes the important aspects of an organ transplant process. It outlines the types of transplants and sources of organs, and examines the patients' perspective. The chapter also considers the existing procurement system and its philosophical-ideological base: altruistic donation.
Athena Liu
- Published in print:
- 2000
- Published Online:
- March 2012
- ISBN:
- 9780198299189
- eISBN:
- 9780191685644
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198299189.003.0028
- Subject:
- Law, Philosophy of Law, Medical Law
Organ transplant raises difficult legal and ethical issues. Organs may come from a live or dead donor, and a donor may be an adult or a minor. This chapter deals with only live adult (over eighteen) ...
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Organ transplant raises difficult legal and ethical issues. Organs may come from a live or dead donor, and a donor may be an adult or a minor. This chapter deals with only live adult (over eighteen) donors and recipients. Live transplant is mainly governed by the Human Organ Transplant Ordinance (HOTO) which has two main objectives: first, to prevent organ trading, which can take two forms: commercial agencies acting as intermediaries between donors and recipients, and recipients buying organs by paying potential donors as a means of inducing a donation which would not otherwise have taken place. The other objective of the HOTO is to protect the right to self-determination of both donors and recipients. The chapter first examines the scope of the HOTO by reference to the meaning of ‘organ’ and ‘payment prohibited’. Parts II and III examine the legal structure for related and unrelated donations and the extent to which the objectives of the HOTO are achieved. Part IV examines the position of adult comatose recipients. In a recent Hong Kong case, such a patient died as a result of not being able to have a liver transplant. The chapter discusses the position of such a patient under a recent amendment to the HOTO and examines one of its implications.Less
Organ transplant raises difficult legal and ethical issues. Organs may come from a live or dead donor, and a donor may be an adult or a minor. This chapter deals with only live adult (over eighteen) donors and recipients. Live transplant is mainly governed by the Human Organ Transplant Ordinance (HOTO) which has two main objectives: first, to prevent organ trading, which can take two forms: commercial agencies acting as intermediaries between donors and recipients, and recipients buying organs by paying potential donors as a means of inducing a donation which would not otherwise have taken place. The other objective of the HOTO is to protect the right to self-determination of both donors and recipients. The chapter first examines the scope of the HOTO by reference to the meaning of ‘organ’ and ‘payment prohibited’. Parts II and III examine the legal structure for related and unrelated donations and the extent to which the objectives of the HOTO are achieved. Part IV examines the position of adult comatose recipients. In a recent Hong Kong case, such a patient died as a result of not being able to have a liver transplant. The chapter discusses the position of such a patient under a recent amendment to the HOTO and examines one of its implications.
Nancy Scheper-Hughes
- Published in print:
- 2006
- Published Online:
- September 2014
- ISBN:
- 9780807830598
- eISBN:
- 9781469605432
- Item type:
- chapter
- Publisher:
- University of North Carolina Press
- DOI:
- 10.5149/9780807877524_wailoo.13
- Subject:
- History, Social History
This chapter presents a global analysis of the phenomenon referred to as “transplant tourism.” It describes how patients with the financial capability procure organ transplants illegally from abroad. ...
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This chapter presents a global analysis of the phenomenon referred to as “transplant tourism.” It describes how patients with the financial capability procure organ transplants illegally from abroad. The globalization of organ and tissue markets highlights how the economic inequities that propelled Jesica and her family to travel to the United States in search of health care also encouraged other poor people of the world into selling their organs.Less
This chapter presents a global analysis of the phenomenon referred to as “transplant tourism.” It describes how patients with the financial capability procure organ transplants illegally from abroad. The globalization of organ and tissue markets highlights how the economic inequities that propelled Jesica and her family to travel to the United States in search of health care also encouraged other poor people of the world into selling their organs.
Rosamond Rhodes and Thomas D. Schiano
- Published in print:
- 2012
- Published Online:
- May 2015
- ISBN:
- 9780199744206
- eISBN:
- 9780190267551
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:osobl/9780199744206.003.0041
- Subject:
- Philosophy, Moral Philosophy
This chapter examines the current national system for allocating transplant organs in the United States. Advancing science that has improved the success of organ transplantation also creates an ...
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This chapter examines the current national system for allocating transplant organs in the United States. Advancing science that has improved the success of organ transplantation also creates an increased demand for life-saving organ transplantation. Systems for organ allocation vividly exemplify a wide-ranging problem of justice. In transplantation of vital solid organs such as liver, the scarcity of what is to be distributed is glaringly obvious while the political forces that affect allocation policy are hard to see. The injustices that result are even harder to discern. Despite the pronounced disparity in waiting times for transplantation, and the disparate treatment for different groups of people who need a transplant organ, the United Network for Organ Sharing system espouses its commitment to justice, equity, and efficacy.Less
This chapter examines the current national system for allocating transplant organs in the United States. Advancing science that has improved the success of organ transplantation also creates an increased demand for life-saving organ transplantation. Systems for organ allocation vividly exemplify a wide-ranging problem of justice. In transplantation of vital solid organs such as liver, the scarcity of what is to be distributed is glaringly obvious while the political forces that affect allocation policy are hard to see. The injustices that result are even harder to discern. Despite the pronounced disparity in waiting times for transplantation, and the disparate treatment for different groups of people who need a transplant organ, the United Network for Organ Sharing system espouses its commitment to justice, equity, and efficacy.
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.
Fay Bound Alberti
- Published in print:
- 2010
- Published Online:
- October 2011
- ISBN:
- 9780199540976
- eISBN:
- 9780191701207
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199540976.001.0001
- Subject:
- History, Cultural History
The heart is the most symbolic organ of the human body. Across cultures it is seen as the site of emotions, as well as the origin of life. We feel emotions in the heart, from the heart-stopping ...
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The heart is the most symbolic organ of the human body. Across cultures it is seen as the site of emotions, as well as the origin of life. We feel emotions in the heart, from the heart-stopping sensation of romantic love to the crushing sensation of despair. And yet since the nineteenth century the heart has been redefined in medical terms as a pump, an organ responsible for the circulation of the blood. Emotions have been removed from the heart as an active site of influence and towards the brain. It is the brain that is the organ most commonly associated with emotion in the modern West. So why, then, do the emotional meanings of the heart linger? Why do many transplantation patients believe that the heart, for instance, can transmit memories and emotions and why do we still refer to emotions as ‘heartfelt’? We cannot answer these questions without reference to the history of the heart as both physical organ and emotional symbol. Matters of the Heart traces the ways emotions have been understood between the seventeenth and nineteenth centuries as both physical entities and spiritual experiences. With reference to historical interpretations of such key concepts as gender, emotion, subjectivity, and the self, it also addresses the shifting relationship from heart to brain as competing centres of emotion in the West.Less
The heart is the most symbolic organ of the human body. Across cultures it is seen as the site of emotions, as well as the origin of life. We feel emotions in the heart, from the heart-stopping sensation of romantic love to the crushing sensation of despair. And yet since the nineteenth century the heart has been redefined in medical terms as a pump, an organ responsible for the circulation of the blood. Emotions have been removed from the heart as an active site of influence and towards the brain. It is the brain that is the organ most commonly associated with emotion in the modern West. So why, then, do the emotional meanings of the heart linger? Why do many transplantation patients believe that the heart, for instance, can transmit memories and emotions and why do we still refer to emotions as ‘heartfelt’? We cannot answer these questions without reference to the history of the heart as both physical organ and emotional symbol. Matters of the Heart traces the ways emotions have been understood between the seventeenth and nineteenth centuries as both physical entities and spiritual experiences. With reference to historical interpretations of such key concepts as gender, emotion, subjectivity, and the self, it also addresses the shifting relationship from heart to brain as competing centres of emotion in the West.
Rosamond Rhodes
- Published in print:
- 2006
- Published Online:
- September 2014
- ISBN:
- 9780807830598
- eISBN:
- 9781469605432
- Item type:
- chapter
- Publisher:
- University of North Carolina Press
- DOI:
- 10.5149/9780807877524_wailoo.11
- Subject:
- History, Social History
Focusing on the central ethical issue of Jesica Santillan's case, this chapter discusses the question of whether transplant organs were allocated justly. Specifically, it analyzes how notions of ...
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Focusing on the central ethical issue of Jesica Santillan's case, this chapter discusses the question of whether transplant organs were allocated justly. Specifically, it analyzes how notions of justice should, and should not influence organ matching and that organ allocation should be governed by the principles of “clinical justice”. The chapter also provides insight on the United Network for Organ Sharing (UNOS) policy and the ways in which issues of urgency, efficacy, equity, and the interests of small transplant centers are weighed in organ allocation.Less
Focusing on the central ethical issue of Jesica Santillan's case, this chapter discusses the question of whether transplant organs were allocated justly. Specifically, it analyzes how notions of justice should, and should not influence organ matching and that organ allocation should be governed by the principles of “clinical justice”. The chapter also provides insight on the United Network for Organ Sharing (UNOS) policy and the ways in which issues of urgency, efficacy, equity, and the interests of small transplant centers are weighed in organ allocation.
- Published in print:
- 2013
- Published Online:
- June 2013
- ISBN:
- 9780804784092
- eISBN:
- 9780804784641
- Item type:
- chapter
- Publisher:
- Stanford University Press
- DOI:
- 10.11126/stanford/9780804784092.003.0004
- Subject:
- Economics and Finance, Public and Welfare
This chapter makes the medical and financial case for large increases in transplant activity. It reviews studies that examine in detail the social costs and benefits of various transplants, and ...
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This chapter makes the medical and financial case for large increases in transplant activity. It reviews studies that examine in detail the social costs and benefits of various transplants, and finds, consistent with overwhelming medical opinion, that transplantation is the best and most cost-effective treatment for a number of serious disorders. In the case of kidney transplants and end-stage renal disease, one can justify paying very large compensation to donors (or their families) based solely on savings to public health funds. Many billions of dollars or euros are lost every year through continued reliance on the current system of organ procurement. In contrast, it is more difficult to rationalize large increases in certain other transplant procedures purely based on direct medical cost effects. It is unlikely, given current technological constraints and life expectancies, that large expansions in heart-lung transplants will “pay for themselves” in this sense.Less
This chapter makes the medical and financial case for large increases in transplant activity. It reviews studies that examine in detail the social costs and benefits of various transplants, and finds, consistent with overwhelming medical opinion, that transplantation is the best and most cost-effective treatment for a number of serious disorders. In the case of kidney transplants and end-stage renal disease, one can justify paying very large compensation to donors (or their families) based solely on savings to public health funds. Many billions of dollars or euros are lost every year through continued reliance on the current system of organ procurement. In contrast, it is more difficult to rationalize large increases in certain other transplant procedures purely based on direct medical cost effects. It is unlikely, given current technological constraints and life expectancies, that large expansions in heart-lung transplants will “pay for themselves” in this sense.
- 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.
Sharrona Pearl
- Published in print:
- 2017
- Published Online:
- September 2017
- ISBN:
- 9780226461229
- eISBN:
- 9780226461533
- Item type:
- chapter
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226461533.003.0002
- Subject:
- History, History of Science, Technology, and Medicine
This chapter explores the history of cosmetic surgery and its intersections with transplants, showing how FAT is both and neither and something else entirely. Through a deep dive into the literature ...
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This chapter explores the history of cosmetic surgery and its intersections with transplants, showing how FAT is both and neither and something else entirely. Through a deep dive into the literature of cosmetic surgery, the chapter maps the discursive terrain on which face transplants have been charted, discussing the rhetoric of facial manipulation in the context of FAT. If the lack of a face is a debilitating medical condition for which a transplant is the cure, what is the difference between that and a more cosmetic intervention—is it a difference of degree or kind? The narrative differentiating the former from the latter, this chapter shows,is one of risk: the risk of the operation and especially of the lifetime on immunosuppressants while living with a new face. But risk is just an excuse that obscures the true source of our objections. After a discussion of the first transplants and their relationship to the birth of bioethics as a field, the chapter explores the first facial reattachment and reactions to it. It moves to fears of identity transfer and cellular memory, tracking the literary and cultural manifestations of these phenomena, thinking about how these concerns impact conceptions of transplant surgeries more broadly.Less
This chapter explores the history of cosmetic surgery and its intersections with transplants, showing how FAT is both and neither and something else entirely. Through a deep dive into the literature of cosmetic surgery, the chapter maps the discursive terrain on which face transplants have been charted, discussing the rhetoric of facial manipulation in the context of FAT. If the lack of a face is a debilitating medical condition for which a transplant is the cure, what is the difference between that and a more cosmetic intervention—is it a difference of degree or kind? The narrative differentiating the former from the latter, this chapter shows,is one of risk: the risk of the operation and especially of the lifetime on immunosuppressants while living with a new face. But risk is just an excuse that obscures the true source of our objections. After a discussion of the first transplants and their relationship to the birth of bioethics as a field, the chapter explores the first facial reattachment and reactions to it. It moves to fears of identity transfer and cellular memory, tracking the literary and cultural manifestations of these phenomena, thinking about how these concerns impact conceptions of transplant surgeries more broadly.
Daniel B. Sinclair
- Published in print:
- 2003
- Published Online:
- March 2012
- ISBN:
- 9780198268277
- eISBN:
- 9780191683480
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198268277.003.0006
- Subject:
- Law, Medical Law
This chapter discusses the following topics: the definition of death, heart transplants, organ donations, the gap between the halakhah and modern organ transplant policy, and the rationing of scarce ...
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This chapter discusses the following topics: the definition of death, heart transplants, organ donations, the gap between the halakhah and modern organ transplant policy, and the rationing of scarce medical resources.Less
This chapter discusses the following topics: the definition of death, heart transplants, organ donations, the gap between the halakhah and modern organ transplant policy, and the rationing of scarce medical resources.
Daniel Sperling
- Published in print:
- 2014
- Published Online:
- August 2014
- ISBN:
- 9780199688999
- eISBN:
- 9780191768118
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199688999.003.0013
- Subject:
- Law, Medical Law
This chapter discusses the health risks associated with living donations; the legal responses to and management of organ trade under the trafficking framework; and the problematic association between ...
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This chapter discusses the health risks associated with living donations; the legal responses to and management of organ trade under the trafficking framework; and the problematic association between organ trade and human trafficking. Analysis of case law in various countries reveals that the law, and especially the re-formulation of organ trade under the criminal offence of human trafficking, is insufficient and ineffective and does not pay serious attention to the physical harm that may be associated with itLess
This chapter discusses the health risks associated with living donations; the legal responses to and management of organ trade under the trafficking framework; and the problematic association between organ trade and human trafficking. Analysis of case law in various countries reveals that the law, and especially the re-formulation of organ trade under the criminal offence of human trafficking, is insufficient and ineffective and does not pay serious attention to the physical harm that may be associated with it
Anne Phillips
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691150864
- eISBN:
- 9781400846368
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691150864.003.0005
- Subject:
- Philosophy, Political Philosophy
This chapter moves on to markets in body tissues and parts, focusing on the trade in live kidneys. Given the risks to vendors, and the significant number of patients dying each year while waiting for ...
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This chapter moves on to markets in body tissues and parts, focusing on the trade in live kidneys. Given the risks to vendors, and the significant number of patients dying each year while waiting for a transplant, why not make the transactions more open? Why not allow people to sell nonvital parts of their body while they are still alive? If we allow them to donate, we presumably do not consider the health risks prohibitive. Why not also allow them to sell? It is argued that the kidney trade relies on and undermines our status as equals. The chapter also returns to claims about property as protection, restating and developing reservations about those who favor more body property as a means to resist excessive marketization.Less
This chapter moves on to markets in body tissues and parts, focusing on the trade in live kidneys. Given the risks to vendors, and the significant number of patients dying each year while waiting for a transplant, why not make the transactions more open? Why not allow people to sell nonvital parts of their body while they are still alive? If we allow them to donate, we presumably do not consider the health risks prohibitive. Why not also allow them to sell? It is argued that the kidney trade relies on and undermines our status as equals. The chapter also returns to claims about property as protection, restating and developing reservations about those who favor more body property as a means to resist excessive marketization.
Philip M. Rosoff
- Published in print:
- 2014
- Published Online:
- January 2015
- ISBN:
- 9780262027496
- eISBN:
- 9780262320764
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262027496.003.0002
- Subject:
- Biology, Bioethics
This chapter initiates the main argument by describing in detail three systems of open, formal rationing in American healthcare: solid organ transplantation, scarce drug allocation, and the Oregon ...
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This chapter initiates the main argument by describing in detail three systems of open, formal rationing in American healthcare: solid organ transplantation, scarce drug allocation, and the Oregon Health Plan (created in the late 1980s to improve and expand medical care for poor residents of the state). While there are clear differences between the three approaches, as well as dissimilar goals and aims, they bear striking similarities in several crucial domains. Remarkably, all three systems have been accepted not only by the people immediately affected (patients), but also by the public in general, indicating that rationing per se may not be as intolerable as suspected.Less
This chapter initiates the main argument by describing in detail three systems of open, formal rationing in American healthcare: solid organ transplantation, scarce drug allocation, and the Oregon Health Plan (created in the late 1980s to improve and expand medical care for poor residents of the state). While there are clear differences between the three approaches, as well as dissimilar goals and aims, they bear striking similarities in several crucial domains. Remarkably, all three systems have been accepted not only by the people immediately affected (patients), but also by the public in general, indicating that rationing per se may not be as intolerable as suspected.
K. Kannan
- Published in print:
- 2014
- Published Online:
- April 2014
- ISBN:
- 9780198082880
- eISBN:
- 9780199082827
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198082880.003.0010
- Subject:
- Law, Medical Law
Prolongation of life and improvement of quality of health assumed immense possibilities with organ transplants from live and deceased donors. When a person can be treated as dead in order for organs ...
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Prolongation of life and improvement of quality of health assumed immense possibilities with organ transplants from live and deceased donors. When a person can be treated as dead in order for organs to be harvested for transplant and when life support can be withdrawn from a critically ill patient requires close monitoring and the Organ Transplantation Act contains empowering provisions to mitigate the dilemma. Issues of consent are vital to proper implementation of the Act and since they are emotive, often arising during the time of critical care of the patient, advance directives and the surrogate decisions of near relatives assume significance. Statutory controls have not quelled either the organ trade or manipulation of authorization committees’ recommendations. Prices for organs to check the scourge of black market trade in organs may seem an attractive proposition but in a country of countless indigent persons, they are bound to result in exploitation of the poor.Less
Prolongation of life and improvement of quality of health assumed immense possibilities with organ transplants from live and deceased donors. When a person can be treated as dead in order for organs to be harvested for transplant and when life support can be withdrawn from a critically ill patient requires close monitoring and the Organ Transplantation Act contains empowering provisions to mitigate the dilemma. Issues of consent are vital to proper implementation of the Act and since they are emotive, often arising during the time of critical care of the patient, advance directives and the surrogate decisions of near relatives assume significance. Statutory controls have not quelled either the organ trade or manipulation of authorization committees’ recommendations. Prices for organs to check the scourge of black market trade in organs may seem an attractive proposition but in a country of countless indigent persons, they are bound to result in exploitation of the poor.
Leonardo D. de Castro
- Published in print:
- 2014
- Published Online:
- January 2014
- ISBN:
- 9780199682676
- eISBN:
- 9780191763168
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199682676.003.0062
- Subject:
- Philosophy, Moral Philosophy
The paradigm of the family as the basic unit of society has been facing challenges, perhaps the most prominent of which have come in areas of biotechnology and health care. Those challenges are ...
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The paradigm of the family as the basic unit of society has been facing challenges, perhaps the most prominent of which have come in areas of biotechnology and health care. Those challenges are requiring flexibility in defining the boundaries that define membership of a family. The frontiers of interdependence, reciprocity and responsibility are having to be adjusted and responsibility for health concerns is extending way beyond genetic family borders. This is an empirical development that will continue to prevail whether we recognize it or not. As social beings, human beings have engaged in close social relationships that transcend blood ties. It would be wrong to continue to predicate organ transplant policies solely on genetic relationships. While there is a need to be wary of commercially motivated claims to kinships the concern must be tempered by openness to emerging types of human bonds and to emerging conceptions of the family.Less
The paradigm of the family as the basic unit of society has been facing challenges, perhaps the most prominent of which have come in areas of biotechnology and health care. Those challenges are requiring flexibility in defining the boundaries that define membership of a family. The frontiers of interdependence, reciprocity and responsibility are having to be adjusted and responsibility for health concerns is extending way beyond genetic family borders. This is an empirical development that will continue to prevail whether we recognize it or not. As social beings, human beings have engaged in close social relationships that transcend blood ties. It would be wrong to continue to predicate organ transplant policies solely on genetic relationships. While there is a need to be wary of commercially motivated claims to kinships the concern must be tempered by openness to emerging types of human bonds and to emerging conceptions of the family.
Philip M. Rosoff
- Published in print:
- 2014
- Published Online:
- January 2015
- ISBN:
- 9780262027496
- eISBN:
- 9780262320764
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262027496.003.0001
- Subject:
- Biology, Bioethics
This chapter introduces the concept of the need for organized healthcare rationing after first discussing the dysfunctions of the healthcare system in the United States: its disorder, gross ...
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This chapter introduces the concept of the need for organized healthcare rationing after first discussing the dysfunctions of the healthcare system in the United States: its disorder, gross inefficiency, inequities, failure to offer insurance to vast numbers of Americans, and enormous (and escalating) costs. It introduces the topic of established open and overt rationing systems in the US, such as that for solid organ transplantation, and suggests that they are accepted – even embraced – by most of the public. If rationing is believed to be anathema, why is this so? It begins an argument that there may be features of the transplant (and other rationing schemes) that contribute to their acceptability, despite the fact that people who fail to receive an organ almost inevitably die.Less
This chapter introduces the concept of the need for organized healthcare rationing after first discussing the dysfunctions of the healthcare system in the United States: its disorder, gross inefficiency, inequities, failure to offer insurance to vast numbers of Americans, and enormous (and escalating) costs. It introduces the topic of established open and overt rationing systems in the US, such as that for solid organ transplantation, and suggests that they are accepted – even embraced – by most of the public. If rationing is believed to be anathema, why is this so? It begins an argument that there may be features of the transplant (and other rationing schemes) that contribute to their acceptability, despite the fact that people who fail to receive an organ almost inevitably die.
Leonardo D. de Castro and Peter A. Sy
- Published in print:
- 2014
- Published Online:
- January 2014
- ISBN:
- 9780199682676
- eISBN:
- 9780191763168
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199682676.003.0057
- Subject:
- Philosophy, Moral Philosophy
This paper explores a model for reciprocating the contribution of organ donors to a health care system characterized by inadequate resources and faced with the challenge of trying innovative ways of ...
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This paper explores a model for reciprocating the contribution of organ donors to a health care system characterized by inadequate resources and faced with the challenge of trying innovative ways of providing much needed health care. The conceptual exploration recognizes the soft altruism manifested in the contributions made by people who donate in the context of a social amelioration scheme. In order to bring out some of the model’s characteristic features, a comparison is made with a presumed consent regime, which, while focused on cadaver organs, would appear to take advantage of the vulnerabilities of the poor when implemented in economically disadvantaged countries. The model examines whether it would be possible for poor organ donors to donate organs as part of such a scheme and emerge in an improved socio-economic situation, better health, without loss of dignity.Less
This paper explores a model for reciprocating the contribution of organ donors to a health care system characterized by inadequate resources and faced with the challenge of trying innovative ways of providing much needed health care. The conceptual exploration recognizes the soft altruism manifested in the contributions made by people who donate in the context of a social amelioration scheme. In order to bring out some of the model’s characteristic features, a comparison is made with a presumed consent regime, which, while focused on cadaver organs, would appear to take advantage of the vulnerabilities of the poor when implemented in economically disadvantaged countries. The model examines whether it would be possible for poor organ donors to donate organs as part of such a scheme and emerge in an improved socio-economic situation, better health, without loss of dignity.
