Three decades after the first heart transplant surgery stunned the world, organs including eyes, lungs, livers, kidneys, and hearts are transplanted every day. But despite its increasingly routine nature-or perhaps because of it-transplantation offers enormous ethical challenges. A medical ethicist who has been involved in the organ transplant debate for many years, Robert M. Veatch explores a variety of questions that continue to vex the transplantation community, offering his own solutions in many cases.
Ranging from the most fundamental questions to recently emerging issues, Transplantation Ethics is the first complete and systematic account of the ethical and policy controversies surrounding organ transplants. Veatch structures his discussion around three major topics: the definition of death, the procurement of organs, and the allocation of organs. He lobbies for an allocation system-administered by nonphysicians-that considers both efficiency and equity, that takes into consideration the patient's age and previous transplant history, and that operates on a national rather than a regional level.
Rich with case studies and written in an accessible style, this comprehensive reference is intended for a broad cross section of people interested in the ethics of transplantation from either the medical or public policy perspective: patients and their relatives, transplantation professionals, other health care professionals and administrators, social workers, members of organ procurement organizations, and government officials involved in the regulation of transplants.
Table of Contents
Preface
1. Introduction: Religious and Cultural Perspective
2. An Ethical Framework: General Theories of Ethics
Part One: Defining Death
3. The Dead Donor Rule and the Concept of Death
4. The Whole-Brain Concept of Death
5. The Circulatory, or Somatic, Concept of Death
6. The Higher-Brain Concept of Death
7. The Conscience Clause: How Much Individual Choice Can Our Society Tolerate in Defining Death?
8. Crafting a New Definition-of-Death Law
Part Two: Procuring Organs
9. The Donation Model
10. Routine Salvaging and Presumed Consent
11. Markets for Organs
12. Live-Donor Transplants
13. High-Risk Donors
14. Xenotransplants: Using Organs from Animals
15. The Media's Impact on Transplants and Directed Donation
Part Three: Allocating Organs
16. The Roles of the Clinician and the Public
17. A General Moral Theory of Organ Allocation
18. Voluntary Risks and Allocations: Does the Alcoholic Deserve a New Liver?
19. Multi-Organ, Split-Organ, and Repeat Transplants
20. The Role of Age in Allocation
21. The Role of Status: The Case of Mickey Mantle, Robert Casey, Steve Jobs, and Dick Cheney
22. Geography and Other Causes of Allocation Disparities
23. Socially Directed Donation: Restricting Donation by Social Group
24. Elective Organ Transplantation
25. Vascularized Composite Allografts: Hand, Face, and Uterine Transplants
Index
Reviews
"The book on transplantation ethics."—Choice
"Without question, the best and most important book on this topic."—James F. Childress, University of Virginia
"A comprehensive, knowledgable and thoughtful treatise on the critical ethical issues those of us in the transplant field wrestle with each day. Nice job!"—Jimmy A. Light, MD, Director of Transplantation Services, Washington Hospital Center
Awards
Congratulations to Robert M. Veatch, 2008 recipient of the American Society of Bioethics and the Humanities Lifetime Achievment Award.
About the Author
Robert M. Veatch is professor of medical ethics at Georgetown University's Kennedy Institute of Ethics. He has served on the board of the Washington Regional Transplant Consortium since 1988 and on the United Network for Organ Sharing's Ethics Committee from 1989 to 1995, experience that has exposed him to cutting-edge debate on moral and policy issues as they emerge on the national scene. Veatch's books include Source Book in Bioethics, edited with Albert R. Jonsen and LeRoy Walters (Georgetown University Press, 1998), which was named an Outstanding Academic Book by Choice magazine.
