David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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HEC Forum 21 (1):27-53 (2009)
Many people in desperate need of an organ will die on waiting lists for transplantation or face increased morbidity because of their wait. This circumstance is particularly troubling since many viable organs for transplantation go unused when individuals fail to participate in their local organ donation system. In this paper, I consider whether participating in organ transplantation should be considered a form of a rescue of others from the great harms caused by a shortage in transplantable organs. Specifically, I consider whether cadaver organ transplantation is a case of an easy rescue. If so, participation in cadaver organ transplantation will be a duty rather than a supererogatory act.1 This question is important in illuminating individual duties to participate in organ transplantation. Moreover, as I will argue, it has repercussions for community-wide policies for enrolling individuals in transplantation schemes. In the first section of this paper, I tie cadaver organ transplantation to the duty to rescue others from great harm when it is easy to do so. Given the number of persons who will die or be greatly harmed without transplanted organs, the transfer of organs upon death is seemingly similar to other, classical cases of easy rescue. In the second section, I consider objections to this proposal on the ground that cadaver organ transplantation is structurally dissimilar to classical rescue cases, especially given uncertainty over when and to whom organs will be transplanted, if they are transplanted at all. In the third section, I consider the objection that cadaver organ transplantation is a demanding, rather than easy, rescue. While I grant that cadaver organ transplantation will be demanding for some persons, I argue that there remain many cases where it will be an easy rescue. In the final section, I consider the policy implications of my argument. In particular, I argue that understanding cadaver organ transplantation as a duty should shift the debate over opt-out, opt-in, and mandatory choice procedures for participating in organ transplantation upon death. While different systems will be appropriate for different communities, understanding transplantation as a duty in some cases helps to justify an opt-out system.
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References found in this work BETA
Arthur Caplan (1983). Mrs. X and the Bone Marrow Transplant. Hastings Center Report 13 (3):17-19.
James F. Childress (2001). The Failure to Give: Reducing Barriers to Organ Donation. Kennedy Institute of Ethics Journal 11 (1):1-16.
H. E. Emson (2003). It is Immoral to Require Consent for Cadaver Organ Donation. Journal of Medical Ethics 29 (3):125-127.
C. A. Erin & J. Harris (1999). Presumed Consent or Contracting Out. Journal of Medical Ethics 25 (5):365-366.
Michael B. Gill (2004). Presumed Consent, Autonomy, and Organ Donation. Journal of Medicine and Philosophy 29 (1):37 – 59.
Citations of this work BETA
M. J. Cherry (2009). Why Should We Compensate Organ Donors When We Can Continue to Take Organs for Free? A Response to Some of My Critics. Journal of Medicine and Philosophy 34 (6):649-673.
M. J. Cherry (2009). Religion Without God, Social Justice Without Christian Charity, and Other Dimensions of the Culture Wars. Christian Bioethics 15 (3):277-299.
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