Public entities around the world are increasingly deploying artificial intelligence and algorithmic decision-making systems to provide public services or to use their enforcement powers. The rationale for the public sector to use these systems is similar to private sector: increase efficiency and speed of transactions and lower the costs. However, public entities are first and foremost established to meet the needs of the members of society and protect the safety, fundamental rights, and wellbeing of those they (...) serve. Currently AI systems are deployed by the public sector at various administrative levels without robust due diligence, monitoring, or transparency. This paper critically maps out the challenges in procurement of AI systems by public entities and the long-term implications necessitating AI-specific procurement guidelines and processes. This dual-prong exploration includes the new complexities and risks introduced by AI systems, and the institutional capabilities impacting the decision-making process. AI-specific public procurement guidelines are urgently needed to protect fundamental rights and due process. (shrink)

The article “Prevention of corruption in public procurement: importance of general legal principles” examines the importance of general legal principles in the sphere of public purchases. The purpose of the work is to analyse the information on possible methods of prevention of and fight against corruption. The main result of the work is the conclusion that strict adherence to the general legal principles is one of the corruption-reducing factors. While combating corruption in the field of public (...) procurement, general legal principles should not be divided into primary and secondary principles, because they are all equally important and complement each other. Audit of the normative acts regulating public procurement shall be performed in the Member States of the European Union; positivisation of the following principles will effectively prevent manifestations of corruption in the area of public procurement: the principle of responsibility; principle of permanent composition of the procurement commission; the principle of in dubio pro reo; the principle of compensation; the principle of control; the principle of objectivity; the principle of completing the procurement procedure within a reasonable time period. (shrink)

Recommending the identity of bidders in public procurement auctions has a significant impact in many areas of public procurement, but it has not yet been studied in depth. A bidders recommender would be a very beneficial tool because a supplier can search appropriate tenders and, vice versa, a public procurement agency can discover automatically unknown companies which are suitable for its tender. This paper develops a pioneering algorithm to recommend potential bidders using a machine (...) learning method, particularly a random forest classifier. The bidders recommender is described theoretically, so it can be implemented or adapted to any particular situation. It has been successfully validated with a case study: an actual Spanish tender dataset which has 102,087 tenders from 2014 to 2020 and a company dataset which has 1,353,213 Spanish companies. Quantitative, graphical, and statistical descriptions of both datasets are presented. The results of the case study were satisfactory: the winning bidding company is within the recommended companies group, from 24% to 38% of the tenders, according to different test conditions and scenarios. (shrink)

This article discusses the alleged anti-corruption effects of procurement reforms by presenting the European Act on Public Procurement and the increasing number of appeals filed by suppliers due to perceived misevaluations of tenders and perceived impairments of transparency. The delays and costs that arise from this right to appeal are studied in the Swedish context with the aim of contributing to the debate on corruption in two ways. First, instead of using the modern definition of corruption, the (...) ancient definition is introduced to explain anti-corruption efforts, focusing on corruption as deviations from a pristine standard as opposed to corruption as the abuse of public power for private gain. Second, it will be argued that the fight against corruption in the practical implementation of the European Act on Public Procurement jeopardizes efficiency and might devaluate competence. However, striving for the total elimination of corruption–an evil that has to be fought disregarding the consequences–is integral in the war against it. (shrink)

This study investigates the relationship between moral schemas and corruption in public procurement. It adopts a moral schema framework to examine procurement-induced corruption from Uganda. Experiences, attitudes, and values of respondents are used to construct future behavior of public procurement staff. The schema framework was built around the premise that procurement-related corruption is a function of the social framework and human nature paradox, constructing logical justification for the acts of corruption. The study uses data (...) from 474 public procurement staff to demonstrate that social identity, ethical egoistic, legislative, amoral, and religious moral schemas account for 78.51% of the variance in moral schema of respondents. All these schemas were found to be significant predictors, accounting for 73.3% of public procurement corruption. The paper urges managers of procuring and disposing entities to utilize moral scripts in reducing corruption. Managers are encouraged to engage in morally responsible behaviors to promote ethics and value-for-money transactions. The paper provides an alternative framework for examining corruption in sub-Saharan Africa where explicit elaboration of insights on corruption is still lacking. (shrink)

: Although "brain death" and the dead donor rule—i.e., patients must not be killed by organ retrieval—have been clinically and legally accepted in the U.S. as prerequisites to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents ≥18 years were randomly selected and surveyed using random digit dialing (RDD) sample frames. The RDD (...) telephone survey was conducted using computer-assisted telephone interviews. The survey instrument was developed from information provided by 12 focus groups and a pilot study of the questionnaire. Three scenarios based on hypothetical patients were presented: "brain dead," in a coma, or in a persistent vegetative state (PVS). Respondents provided personal assessments of whether the patient in each scenario was dead and their willingness to donate that patient's organs in these circumstances. More than 98 percent of respondents had heard of the term "brain death," but only one-third (33.7%) believed that someone who was "brain dead" was legally dead. The majority of respondents (86.2%) identified the "brain-dead" patient in the first scenario as dead, 57.2 percent identified the patient in a coma as dead (Scenario 2), and 34.1 percent identified the patient in a PVS as dead (Scenario 3). Nearly one-third (33.5%) were willing to donate the organs of patients they classified as alive for at least one scenario, in seeming violation of the dead donor rule. Most respondents were not willing to violate the dead donor rule, although a substantial minority was. However, the majority of respondents were unaware, misinformed, or held beliefs that were not congruent with current definitions of "brain death." This study highlights the need for more public dialogue and education about "brain death" and organ donation. (shrink)

Sustainable Public Food Procurement (SPFP) is gaining recognition for its potential to improve the sustainability of food systems and promote healthier diets. However, SPFP faces various challenges, including coordination issues, actor dynamics, infrastructure limitations, unsustainable habits, and institutional resistance, among others. Drawing upon insights from the Multi-Level Perspective (MLP) on socio-technical transitions and the X-curve model on transition dynamics, this study investigates the role of transition intermediaries in facilitating SPFP-induced transformations in food systems. Focusing on four case studies (...) in Spain, we identify common barriers encountered in SPFP and analyse how distinct types of transition intermediaries contribute individually and collectively to address these challenges. Additionally, we explore how intermediary networks evolve throughout different phases of the transition process. Our findings reveal that SPFP barriers are systemic and interconnected, emphasizing the necessity of collective intermediation to overcome these obstacles. Furthermore, our results reveal how collective intermediation is orchestrated by pivotal intermediaries who mobilize diverse transition intermediaries, shaping multiple transition pathways. These intermediaries operate at both food system regimes and niches, challenging the conventional notion that transformative change can only originate from niche efforts. Lastly, we highlight the dynamic and flexible nature of intermediation in SPFP transitions, underscoring the importance of adaptability in strategies as these transitions evolve over time. Practical implications include the need for context-specific, adaptive approaches and strategies that leverage intermediary diversity. This research offers insights for policymakers, practitioners, and scholars into SPFP and broader transitions towards food systems transformation, fostering a more comprehensive understanding of these transition processes. (shrink)

The government purchasing market constitutes the largest business sector in the world. While marketers would benefit from a deep understanding of both sectors, how the two sectors differ in terms of ethics and strategy largely remains unknown. The purpose of this research, therefore, is to explore differences between the for-profit and not-for-profit sectors on two critical aspects of business-to-business procurement: ethics and strategy. Using survey data from a sample of 328 procurement professionals in the for-profit and not-for-profit sectors, (...) key differences are explored. Findings suggest that buyers in the for-profit sector are more likely to behave opportunistically. Conversely, the buyers’ leaders in the not-for-profit sector behave more opportunistically and are more willing to turn a blind eye to their subordinate buyers’ opportunistic behaviors. In addition, key differences in procurement strategy are unveiled suggesting that not-for-profit procurement practices have some room for improvement. Based on the findings, theoretical and managerial implications are drawn, and a future research agenda is proposed. (shrink)

Cadaver organs should be automatically availableThe shortage of donor organs and tissue for transplantation constitutes an acute emergency which demands radical rethinking of our policies and radical measures. While estimates vary and are difficult to arrive at there is no doubt that the donor organ shortage costs literally hundreds of thousands of lives every year. “In the world as a whole there are an estimated 700 000 patients on dialysis . . .. In India alone 100 000 new patients present (...) with kidney failure each year” . Almost “three million Americans suffer from congestive heart failure . . . deaths related to this condition are estimated at 250 000 each year . . . 27 000 patients die annually from liver disease . . .. In Western Europe as a whole 40 000 patients await a kidney but only . . . 10 000 kidneys”1 become available. Nobody knows how many people fail to make it onto the waiting lists and fail to register in the statistics. “As of 24th November 2002 in the United Kingdom 667 people have donated organs, 2055 people have received transplants, and 5615 people are still awaiting transplants.”2Conscious of the terrible and unnecessary tragedy that figures like these represent I have been advocating for more than 20 years now some radical measures to stem this appalling waste of human life. The measure which is the subject of Hamer and Rivlin’s paper 3 concerns the automatic availability of all cadaver organs—a measure, which I first advocated publicly in 1983.4THE AUTOMATIC AVAILABILITY OF DONOR ORGANSWe need to begin by being clear about just what it is I propose and why. At the moment in the United Kingdom we …. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and (...) data collection were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

Background Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent. Methods An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. (...) Content scores were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent. Results There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20–47), 79% (57–86), and 75% (50–100), respectively. The informed consent score was 0% (0–33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing. Conclusion The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent. (shrink)

The dead donor rule (DDR) governs procuring life-prolonging organs. They should be taken only from deceased donors. Miller and Truog have proposed abandoning the rule when patients have decided to forgo life-sustaining treatment and have consented to procurement. Organs could then be procured from living patients, thus killing them by organ procurement. This proposal warrants careful examination. They convincingly argue that current brain or circulatory death pronouncement misidentifies the biologically dead. After arguing convincingly that physicians already cause death (...) by withdrawing treatment, they claim no bright-line differences preclude organ removal from the living. The argument fails for those who accept the double effect doctrine or other grounds for distinguishing forgoing life support from active, intentional killing. If the goal is determining irreversible loss of somatic function, they correctly label current death pronouncement a “legal fiction.” Recognizing a second, public policy meaning of the term death provides grounds for maintaining the DDR without jeopardizing procurement. (shrink)

Public procurement provides an excellent window into the shaping of corporate social responsibility of companies contracted by the government. To this emerging scholarly realization, we want to add that public procurement provides also the opportunity to examine corporate social responsibility as practiced by public sector organizations. This opportunity enables the investigation of the conditions under which public sector organizations endorse CSR guidelines, adherence to which demonstrates accountability for their service providers’ legal, employment-related practices. Our (...) study examined the possibility that public sector organizations’ CSR is enhanced by maintenance managers’ role dissonance emerging in response to an ethical mismatch between them and their organizations’ official stance concerning whether unethical employment practices of service providers should be sanctioned. We analyzed interviews with 13 managers in charge of contract administration in the area of cleaning and maintenance. Our findings suggest that the role dissonance that emerges in cases of mismatch in ethical orientation rarely enhances more responsible treatment of cleaning employees. We introduce a model indicating the conditions supporting this incident. (shrink)

Recent ethics literature suggests that issues involved in non-heart-beating organ procurement are both highly charged and rather urgent. Some fear that NHB is a public relations disaster waiting to happen or that it will create a backlash against organ donation. The purpose of the study described below was to assess ethics committees' current level of involvement in and readiness for addressing the difficult issues that NHB organ retrieval raises—either proactively through policy development or concurrently through ethics consultation.

Recent ethics literature suggests that issues involved in non-heart-beating organ procurement are both highly charged and rather urgent. Some fear that NHB is a public relations disaster waiting to happen or that it will create a backlash against organ donation. The purpose of the study described below was to assess ethics committees' current level of involvement in and readiness for addressing the difficult issues that NHB organ retrieval raises—either proactively through policy development or concurrently through ethics consultation.

A large U.S. government investigation into arms procurement procedures with corporate contractors has recently led to guilty pleas to fraud and illegal use of classified documents. Operation Ill Wind has brought public attention to the criminal and unethical conduct of large defense contractors in their dealings with the government. This article will review how the defense contract bidding process operates and why illegal activity has been able to compromise the process. We will offer proposals to improve the process (...) in light of the present inquiry. (shrink)

The selection of the procurement model, which is a process of discretion exercised by procurement officials, is crucial to the Public-private Partnership procurement performance. From theoretical analysis and international practice, we could find that the negotiation method is more suitable for complex PPP projects, while the tendering method is widely used in China’s PPP procurement. To analyze the reasons for the phenomenon, we used the logit regression model to examine the influence of regulatory competition, risk (...) aversion preference, and tacit interaction on the procurement model selection based on the data of 8,926 PPP projects from 2009 to 2021 in China. The results indicate that regulatory competition leads to confusion in procurement model selection, while risk aversion preference and tacit interaction significantly promote the application of tendering. Moreover, the heterogeneity analysis of regions and return models prove that provincial capitals and municipalities are more susceptible to regulatory competition, risk aversion preference, and tacit interaction than ordinary cities. Compared with user-pay projects, government-pay projects and viability gap funding projects are more susceptible to regulatory competition and risk aversion preference, and less affected by tacit interaction. Therefore, to optimize the procurement model selection, policymakers should improve procurement policies to reduce the adverse effects of regulatory competition, risk aversion preference, and tacit interactions. (shrink)

If we hope to see values of equality and democracy embodied in our societies’ institutions, then we have a range of good reasons to favor expansive public provision of goods and services, and to oppose many forms of privatization. While Joseph Heath is right to argue that there are at least some forms of ‘anodyne privatization’, and while he is also right to argue for a more nuanced philosophical debate about the different dimensions of choice between forms of (...) class='Hi'>public and private provision, Heath fails to register various regards in which private provision can undermine these central public values. We often have strong egalitarian and democratic reasons to protect zones of decommodification; to resist the imposition of user-charges; and to favor insourcing and direct public procurement over various forms of outsourcing of public services. Public libraries provide a totemic illustration of some of the deep virtues of collective public provision in democratic societies. Overall, our reasons to reject privatization are stronger and more diverse than theorists such as Heath might have supposed. (shrink)

There remains a need to properly analyze the metaphysical assumptions underlying two organ procurement policies: presumed consent and organ sales. Our contention is that if one correctly understands the metaphysics of both the human body and material property, then it will turn out that while organ sales are illiberal, presumed consent is not. What we mean by illiberal includes violating rights of bodily integrity, property, or autonomy, as well as arguing for or against a policy in a manner that (...) runs afoul of Rawlsian public reason. (shrink)

Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means (...) of increasing the procurement rate.In this paper, we meet the main objections to mandated choice . We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation. (shrink)

In 2015 Robert Veatch published the second edition of his Transplantation ethics, this time together with Lainie Ross. The chapters on postmortem organ procurement distinguish between ‘giving’ and ‘taking’ systems, and argue that ‘taking’ systems may promise a greater yield of organs for transplantation, but inevitably violate a requirement of respect for the deceased's autonomy. That argument has been very influential, and is also representative of a way of thinking that is widespread in the literature and in public (...) debate. In this paper I contend that it is conceptually flawed in a number of important respects. These concern the understanding of both the concept of ‘consent’ and the requirement of respect for autonomy, the role of the relatives in any procurement system, and the factors that actually determine the extent to which a system respects autonomy, under any interpretation of that requirement. (shrink)

Organ donation after brain death has been practiced in China since 2003 in the absence of brain death legislation. Similar to international standards, China’s brain death diagnostic criteria include coma, absence of brainstem reflexes, and the lack of spontaneous respiration. The Chinese criteria require that the lack of spontaneous respiration must be verified with an apnea test by disconnecting the ventilator for 8 min to provoke spontaneous respiration. However, we have found publications in Chinese medical journals, in which the donors (...) were declared to be brain dead, yet without an apnea test. The organ procurement procedures started with initiating “intratracheal intubation for mechanical ventilation after brain death,” indicating that a brain death diagnosis was not performed. The purpose of the intubation was not to resuscitate the patient but rather was directly related to facilitating the explantation of organs. Moreover, it was unmistakably stated in two of these publications that the cardiac arrest was induced in these patients without brain death determination by cold St. Thomas cardioplegic solution or other cold myocardial protection solutions. This means that the condition of these donors neither met the criteria of brain death nor that of cardiac death. In other words, the “donor organs” may well have been procured in these cases from living human beings. Thus, brain death definition is abused in China by some individuals for organ harvesting, and a systematic investigation is needed to clarify the situation of organ donation after brain death in China. (shrink)

The imbalance between supply of organs for transplantation and demand for them is widening. Although the current international drive to re-establish procurement via non-heart beating organ donation/donor is founded therefore on necessity, the process may constitute a desirable outcome for patient and family when progression to brain stem death does not occur and conventional organ retrieval from the beating heart donor is thereby prevented. The literature accounts of this practice, however, raise concerns that risk jeopardising professional and public (...) confidence in the broader transplant programme. This article focuses on these clinical, ethical, and legal issues in the context of other approaches aimed at increasing donor numbers. The feasibility of introducing such an initiative will hinge on the ability to reassure patients, families, attendant staff, professional bodies, the wider public, law enforcement agencies, and the media that practitioners are working within explicit guidelines which are both ethically and legally defensible. (shrink)

Military and defense-related procurement has been an important source of technology development across a broad spectrum of industries that account for an important share of United States industrial production. In this book, the author focuses on six general-purpose technologies: interchangeable parts and mass production; military and commercial aircraft; nuclear energy and electric power; computers and semiconductors; the INTERNET; and the space industries. In each of these industries, technology development would have occurred more slowly, and in some case much more (...) slowly or not at all, in the absence of military and defense-related procurement. The book addresses three questions that have significant implications for the future growth of the United States economy. One is whether changes in the structure of the United States economy and of the defense-industrial base preclude military and defense-related procurement from playing the role in the development of advanced technology in the future, comparable to the role it has played in the past. A second question is whether public support for commercially oriented research and development will become an important source of new general-purpose technologies. A third and more disturbing question is whether a major war, or the threat of major war, will be necessary to mobilize the scientific, technical, and financial resources necessary to induce the development of new general-purpose technologies. When the history of United States technology development in the next half century is written, it will focus on incremental rather than revolutionary changes in both military and commercial technology. It will also be written within the context of slower productivity growth than of the relatively high rates that prevailed in the United States in the 1950s and 1960s or during the information technology bubble that began in the early 1990s. These will impose severe constraints on the capacity of the United States to sustain a global-class military posture and a position of leadership in the global economy. (shrink)

China is developing an ethical and sustainable organ donation and procurement system based on voluntary citizen donation. The gift-of-life metaphor has begun to dominate public discussion and education about organ donation. However, ethical and legal problems remain concerning this “gift-of-life” discourse: In what sense are donated organs a “gift-of-life”? What constitutes the ultimate worth of such a gift? On whose authority should organs as a “gift-of-life” be donated? There are no universal answers to these questions; instead, responses must (...) be compatible with local cultural values. This paper argues that from a Confucian point of view, organs should be viewed as a gift from the donor’s family, and that final dispositional authority should also rest with the donor’s family. The worth of such a “gift” rests on the virtue of ren, the origin of which is family love. Ultimately, I will argue that a family-based consent model for deceased organ donation is not merely justified, but morally required in the Chinese cultural context. (shrink)

In 2015 Robert Veatch published the second edition of his Transplantation ethics, this time together with Lainie Ross. The chapters on postmortem organ procurement distinguish between ‘giving’ and ‘taking’ systems, and argue that ‘taking’ systems may promise a greater yield of organs for transplantation, but inevitably violate a requirement of respect for the deceased's autonomy. That argument has been very influential, and is also representative of a way of thinking that is widespread in the literature and in public (...) debate. In this paper I contend that it is conceptually flawed in a number of important respects. These concern the understanding of both the concept of ‘consent’ and the requirement of respect for autonomy, the role of the relatives in any procurement system, and the factors that actually determine the extent to which a system respects autonomy, under any interpretation of that requirement. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 51-52 [Access article in PDF] Congress Considers Incentives for Organ Procurement Alexander S. Curtis [Tables]During the 108th Congressional session, several bills pertaining to ethical incentives for organ donation likely will be introduced. In some cases, they will be similar to bills before the 107th Congress (see Table 1). Bills in both the House of Representatives and the Senate address the establishment (...) and maintenance of donor registries, financial reimbursements for medical and nonmedical expenses incurred by qualifying donors, the presentation of commemorative medals, and tax credits.A bill entitled "Gift of Life Congressional Medal Act" (introduced last year by Senate majority leader Bill Frist (R-TN) as Senate Bill 325), and its corresponding bill of the same title (passed in the House of Representatives last year as H.R. 708), would establish a congressional commemorative medal honoring "any organ donor, or the family or family member of any organ donor." The medal is to be designed and struck with "suitable emblems, devices, and inscriptions" by the Secretary of the Treasury. The eligible donor or donor's family member would be presented with the medal by the Secretary of Health and Human Services. This bill would establish qualifying donations as those of human kidneys, livers, hearts, lungs, pancreases, or any other organ, but excludes corneas and eyes.Another bill, introduced by Representative Michael Bilirakis (R-FL) entitled "Organ Donation Improvement Act" (H.R. 624), would award grants or contracts to states, transplant centers, and qualified organ procurement organizations for the purpose of providing travel, subsistence, and incidental nonmedical expenses to individuals who make living donations. In order to receive reimbursement, the donating individuals must reside in states other than the states in which the intended recipients reside and the annual income of those receiving the organs cannot exceed $35,000. The bill also would appropriate $15,000,000 to make grants to states and public and nonprofit entities for the purpose of carrying out studies, public education demonstrations, and outreach activities "designed to increase the number of organ donors within the state." The bill would be effective from time of enactment through 2005. [End Page 51]Two other bills proposed within the House of Representatives in 2002 called for amendment to the Internal Revenue Code. The "Gift of Life Tax Credit Act (introduced as H.R. 1872 by Representative James Hansen (R-UT)) and the "Help Organ Procurement Expand Act" (introduced as H.R. 2090 by Representative Chris Smith (R-NJ)) present a refundable credit to individuals or to the estates of those who agree either to be living donors or to donate their organs upon death. The "Gift of Life Tax Credit Act" refunds $10,000 to the estates of eligible individuals "for the taxable year which includes the date of the individual's death." The "Help Organ Procurement Expand Act" offers a refund of $2,500 to qualified persons. Donations of kidneys, livers, pancreases, islet cells, lungs, and intestines are accepted, however several conditions restrict permissible donors. The "Gift of Life Tax Credit Act" requires that the legally competent individual's death not be due to a suicide and that the intention to donate was clearly declared. The "Help Organ Procurement Expand Act" prohibits donations from individuals who were killed with physician assistance, died as a result of a suicide, have been indicted or convicted of a felony or a misdemeanor offense, or are actively under criminal investigation for a possible felony offense. The "Help Organ Procurement Expand Act" also restricts procuring organs from unborn children or human fetuses and under circumstances in which the living donor would be subject to "unacceptable levels of medical risk of death or permanent debilitation." Alexander S. Curtis is a research assistant at the Kennedy Institute of Ethics, Georgetown University, Washington, DC. He received his bachelor's degree from Miami University.... (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted (...) by two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

Advancements in scientific research and technological development influence the practice of organ donation and organ transplantation. Many SRTD governance discourses put forward the need for multi-stakeholder engagements. We posit that staff employed by organ procurement organizations have a stake in the discussions around SRTD applicable to ODOT because SRTD is one factor that shapes ODOT and because staff are involved in ODOT education and awareness raising while acting as a nexus between donors and the public. Therefore, we performed (...) a content analysis of eight semi-structured in-depth interviews with staff of one Canadian organ procurement organization to ascertain the views that staff had on the use of SRTD in ODOT in general; specific SRTD envisioned to be used in the future in ODOT namely xenotransplantation, embryonic and non-embryonic stem cells, cloning, bionic/artificial organs, and 3-D printed organs; and the emerging ability of SRTD applicable in ODOT to enhance bodily abilities beyond the normal. We found that staff had views on the topics covered in this study, and staff acknowledged that they do not possess sufficient knowledge to be able to engage meaningfully in governance discussions of the SRTD covered and to educate others on these SRTDs. We recommend implementing continuous education for the staff on SRTD envisioned to be applied in ODOT as a capacity-building measure to enable their participation in the governance discussions of these SRTDs and to enhance their ability to educate others on ODOT applicable SRTD. (shrink)

The organ transplantation enterprise is morally flawed. “Brain‐dead” donors are the primary source of solid vital organs, and the transplantation enterprise emphasizes that such donors are dead before organs are removed—or in other words that the dead donor rule is followed. However, individuals meeting standard diagnostic criteria for brain death—unresponsiveness, brainstem areflexia, and apnea—are still living, from a physiological perspective. Therefore, removing vital organs from a heart‐beating, mechanically ventilated donor is lethal. But neither donors nor surrogates nor the public (...) in general are typically informed of this obviously relevant information. Therefore, donors or surrogates do not provide valid consent for a lethal medical procedure. This is a serious moral failing on the part of the transplant community. To address this concern, I advocate for accurate and fully transparent communication of information to the public to allow for an informed civic dialogue about the ethics and legality of lethal organ procurement. Furthermore, I advocate that systems be put in place by the transplant community to allow for valid consent for lethal organ procurement. (shrink)

Altruism and solidarity are concepts that are closely related to organ donation for transplantation. On the one hand, they are typically used for encouraging people to donate. On the other hand, they also underpin the regulations in force in each country to different extents. They are often used indistinctly and equivocally, despite the different ethical implications of each concept. This paper aims to clarify to what extent we can speak of altruism and solidarity in the predominant models of organ donation. (...) It also raises the ethical question of whether these categories are adequate as a basis for such models, bearing in mind that organs are a scarce resource and that a shortage of them may mean that fewer lives are saved or improved. (shrink)

There are not many international consensuses in the governance of biomedicine. One that exists concerns a general reluctance toward a commercialization of organ procurement. However, with reference to the problem of there is an increasingly louder call in ethical and legal discourse to and to establish a debate on financial incentives Other ethicists and jurists criticize this development, and warn of injustice, exploitation of the poor, and a commodification of the human body.

An arms race for an artificial general intelligence would be detrimental for and even pose an existential threat to humanity if it results in an unfriendly AGI. In this paper, an all-pay contest model is developed to derive implications for public policy to avoid such an outcome. It is established that, in a winner-takes-all race, where players must invest in R&D, only the most competitive teams will participate. Thus, given the difficulty of AGI, the number of competing teams is (...) unlikely ever to be very large. It is also established that the intention of teams competing in an AGI race, as well as the possibility of an intermediate outcome, is important. The possibility of an intermediate prize will raise the probability of finding the dominant AGI application and, hence, will make public control more urgent. It is recommended that the danger of an unfriendly AGI can be reduced by taxing AI and using public procurement. This would reduce the pay-off of contestants, raise the amount of R&D needed to compete, and coordinate and incentivize co-operation. This will help to alleviate the control and political problems in AI. Future research is needed to elaborate the design of systems of public procurement of AI innovation and for appropriately adjusting the legal frameworks underpinning high-tech innovation, in particular dealing with patenting by AI. (shrink)

Scientific developments of the last 20 years have made the transplantation of cadaveric solid organs a viable and expected treatment alternative for patients suffering from various forms of End Stage Organ Disease. Of the number of organs that could be utilized for this, only a small percentage of them are actually made available. North American legislation explicitly categorizes the transfer of cadaveric organs as an anatomical or tissue “gift”. The concept of the gift is mediated by transculturally consistent unwritten, but (...) powerfully felt, rules of conduct. Among the most profound elements of the concept is the obligatory gift-exchange which is central to the gift-relationship. Obviously, neither of these are permitted by the organ transplant scenario. As a result, dissonance is created within the thought process of the individual which cannot be easily resolved, paralyzing many into inaction. We maintain that the present legal framework, designed to facilitate the transfer of organs, clashes with the human phenomenon of giving, and may actually prevent organs from being made available. In a search for a solution to this gift-relationship dilemma, giving organs is contrasted with taking organs as a basis upon which to ground ethically sound public policy. Liberty-limiting principles and the concept of harm are considered within this context. (shrink)

Recent calls for retraction of a large body of Chinese transplant research and of Dr Jiankui He’s gene editing research has led to renewed interest in the question of publication, retraction and use of unethical biomedical research. In Part 1 of this paper, we briefly review the now well-established consequentialist and deontological arguments for and against the use of unethical research. We argue that, while there are potentially compelling justifications for use under some circumstances, these justifications fail when unethical practices (...) are ongoing—as in the case of research involving transplantations in which organs have been procured unethically from executed prisoners. Use of such research displays a lack of respect and concern for the victims and undermines efforts to deter unethical practices. Such use also creates moral taint and renders those who use the research complicit in continuing harm. In Part 2, we distinguish three dimensions of ‘non-use’ of unethical research: non-use of published unethical research, non-publication, and retraction and argue that all three types of non-use should be upheld in the case of Chinese transplant research. Publishers have responsibilities to not publish contemporary unethical biomedical research, and where this has occurred, to retract publications. Failure to retract the papers implicitly condones the research, while uptake of the research through citations rewards researchers and ongoing circulation of the data in the literature facilitates subsequent use by researchers, policymakers and clinicians. (shrink)

Schweda and Schicktanz argue that the debate over the ethics of using financial incentives to procure human transplant organs rests on socioempirical premises that need to be critically assessed. They contend that once this is achieved a completely new perspective on the debate should be adopted, with organ donation being viewed primarily as a reciprocal social interaction between donor and recipient. This paper challenges this conclusion, arguing that rather than supporting a new perspective on the debate over the commercial (...) class='Hi'>procurement of organs, the observations of Schweda and Schicktanz support the view that human organs should be commercialized. (shrink)

Dialectic IV convenes contributions with new takes on the long held proposition that architects are providers of design services. They service everyone from the status quo all the way to the subaltern. We know well how architects have historically fashioned themselves to be able to procure the most valued building commissions a people have to offer. There are temples, churches, and shrines, palaces and private villas, and surely monuments, state institutions, and corporate headquarters. But how have the members of the (...) same profession managed to fashion themselves as the custodians of the public good? (shrink)

In the article, we analyse ethical and moral issues of public administration in region of Eastern Slovakia through some cases of the last years. We focused on self-governing regions, namely the Košice and Prešov self-governing regions. We identified two fundamental situations where failures on the side of public administrators occur: selection processes for vacant positions, be it directly in public administration or institutions that fall under its domain, and public procurement with regard to the acquisition (...) of goods and services. The year 2009 was the year of elections to self-governing regions which is why a great number of negative cases dealt with the election campaign. Further, we stated that negative cases dealt with failures of bodies of self-governing regions from both the legal (breaking the law) and moral viewpoint. By claiming that public administrators failed morally, we meant breaking moral norms and rules. Contradictions, which were identified (from the ethical viewpoint), predominantly result from the conflict between public and private interests. In many cases, private interests of public administrators are preferred at the expense of public interests. And it is exactly this preference (a conflict of interests) that is sensitively perceived by the public. (shrink)

This article concerns the implementation of new EU Directives coordinating the procedures for awarding public contracts in European Union Member States. In a number of countries, including Poland, the process of their implementation (Directive 2014/24/eu of the European Parliament and of the Council of 26 February 2014 on public procurement; Directive 2014/25/eu of the European Parliament and of the Council of 26 February 2014 on procurement by entities operating in the water, energy, transport, and postal services (...) sectors; Directive 2014/23/eu of the European Parliament and of the Council of 26 February 2014 on the award of concession contracts) was delayed. In most cases, the modernization of EU regulations on public procurement required a thorough modification of national regulations in this respect. As a result of the introduction of the package of new Directives, the European Union public procurement market has undergone substantial changes. The need to adjust legal regulations to the changing political, social, and economic situations in a better way has resulted in the transposition of the modernized EU Directives concerning public procurement to the Polish legal system, affecting the final shape of the new Polish Public Procurement Law. The implementation of the package of new Directives has significantly affected the functioning of the Polish public procurement market. For the entities operating in this market, this means the necessity to expand their knowledge, so as to become familiar with the new legal solutions in this respect. (shrink)

By the mid-1960s, nonhuman primates had become key experimental organisms for vaccine development and testing, and was seen by many scientists as important for the future success of this field as well as other biomedical undertakings. A major hindrance to expanding the use of nonhuman primates was the dependency on wild-captured animals. In addition to unreliable access and poor animal health, procurement of wild primates involved the circulation of infectious diseases and thus also public health hazards. This paper (...) traces how the World Health Organization (WHO) became involved in the issue of primate supply, and shows how by the late 1960s concerns for vaccine development and the conservation of wildlife began to converge. How did the WHO navigate public health and animal health? What characterized the response and with what implications for humans and animals? The paper explores how technical standards of care were central to managing the conflicting concerns of animal and human health, biological standardization, and conservation. While the WHO’s main aim was to prevent public health risks, I argue that imposing new standards of care implied establishing new hierarchies of humans and animals, and cultures of care. (shrink)

A large body of experience and expertise on the implementation of sustainable public school food procurement policies has developed in recent years. However, there has been little investigation of the values and motivations of the public officials implementing the policies. To address this gap, we examine how the city of Avignon took a step toward transition to local fresh food procurement for public schools, under French government calls for sustainable food products in public canteens. (...) Our analysis combines the Multi-Level Perspective on sustainable transitions with the Public Service Motivation construct. Unlike other studies addressing the MLP at a macro level, we focus on individual motivations behind public action. We demonstrate that staff motivations have a major impact on how policies supporting transition to local fresh food procurement for public schools are implemented. These public officials’ approach to food shows concern for the public interest regardless of financial return. It is not the rational choice that primarily drives the implementation of urban food policies, but normative conformity and affective bonding. Interestingly, we conclude that the success of Avignon’s politically-driven school food procurement policy is essentially due to the catering and procurement staff who overcame the barriers to its implementation. (shrink)

: This commentary distinguishes five reasons why one might want to conduct a survey concerning people's beliefs about death and the permissibility of harvesting organs: (1) simply to learn what people know and want; (2) to determine if current law and practice conform to the wishes of the population; (3) to determine the level of popular support for or opposition to policy changes; (4) to ascertain the causes and effects of popular beliefs and attitudes; and (5) to provide guidance in (...) determining which laws and practices are ethical. The commentary expresses qualms about how well surveys in general can perform with respect to the fifth objective, and it provides specific reasons to doubt whether this survey is informative from the perspective of a moral philosopher concerned with the nature of death and the contours of a permissible system of organ procurement. (shrink)

This book brings together a large and diverse collection of philosophical papers addressing a wide variety of public policy issues. Topics covered range from long-standing subjects of debate such as abortion, punishment, and freedom of expression, to more recent controversies such as those over gene editing, military drones, and statues honoring Confederate soldiers. Part I focuses on the criminal justice system, including issues that arise before, during, and after criminal trials. Part II covers matters of national defense and sovereignty, (...) including chapters on military ethics, terrorism, and immigration. Part III, which explores political participation, manipulation, and standing, includes discussions of issues involving voting rights, the use of nudges, and claims of equal status. Part IV covers a variety of issues involving freedom of speech and expression. Part V deals with questions of justice and inequality. Part VI considers topics involving bioethics and biotechnology. Part VII is devoted to beginning of life issues, such as cloning and surrogacy, and end of life issues, such as assisted suicide and organ procurement. Part VIII navigates emerging environmental issues, including treatments of the urban environment and extraterrestrial environments. (shrink)

The debate over financial incentives and market models for organ procurement represents a key trend in recent bioethics. In this paper, we wish to reassess one of its central premises—the idea of organ shortage. While the problem is often presented as an objective statistical fact that can be taken for granted, we will take a closer look at the underlying framework expressed in the common rhetoric of “scarcity”, “shortage” or “unfulfilled demand”. On the basis of theoretical considerations as well (...) as a socioempirical examination of public attitudes, we will argue that this rhetoric has an economic subtext that imbues the debate with normative premises that have far-reaching social and ethical consequences and need to be made explicit and discussed. (shrink)

BackgroundInternational guidelines on research have focused on protecting research participants. Ethical Research Committee (ERC) approval and informed consent are the cornerstones. Externally sponsored research requires approval through ethical review in both the host and the sponsoring country. This study aimed to determine to what extent ERC approval and informed consent procedures are documented in locally and internationally published human subject research carried out in Sri Lanka.MethodsWe obtained ERC approval in Sri Lanka and the United Kingdom. Theses from 1985 to 2005 (...) available at the Postgraduate Institute of Medicine (PGIM) library affiliated to the University of Colombo were scrutinised using checklists agreed in consultation with senior research collaborators. A Medline search was carried out with MeSH major and minor heading 'Sri Lanka' as the search term for international publications originating in Sri Lanka during 1999 to 2004. All research publications from CMJ during 1999 to 2005 were also scrutinized.ResultsOf 291 theses, 34% documented ERC approvals and 61% documented obtaining consent. From the international journal survey, 250 publications originated from Sri Lanka of which only 79 full text original research publications could be accessed electronically. Of these 38% documented ERC approval and 39% documented obtaining consent. In the Ceylon Medical Journal 36% documented ERC approval and 37% documented obtaining consent.ConclusionOnly one third of the publications scrutinized recorded ERC approval and procurement of informed consent. However, there is a positive trend in documenting these ethical requirements in local postgraduate research and in the local medical journal. (shrink)

In Canada, as in many other countries, there exists an organ procurement/donation crisis. This paper reviews some of the most common kidney procurement and allocation programmes, analyses them in terms of public and private administration, and argues that privately administered living donor models are an inequitable stopgap measure, the good intentions of which are misplaced and opportunistic. Focusing on how to improve the publicly administered equitable cadaveric donation programme, and at the same time offering one possible explanation (...) for its current failure, it is suggested that the simple moral principle of “give and you shall receive”, already considered by some, be extended further. This would allow for those who are willing to sign up to be a public cadaveric donor be given a priority for receiving an organ donation should they ever require it. It is argued that this priority may provide the motivation to give that is so far lacking in Canada. This model is called the Public Cadaveric Organ Donation Program. (shrink)