The Ethics of Organ Transplants: The Current Debate

By Arthur L. Caplan; Daniel H. Coelho | Go to book overview
Save to active project

27. Rationing Failure:
The Ethical Lessons of the
Retransplantation of
Scarce Vital Organs

Peter A. Ubel, Robert M. Arnold,
Arthur L. Caplan

Vital organ transplantation has captured the attention of the medical community and the public in part because of the tragic choices the transplant community must make every day. The demand for vital cadaver organs far exceeds the supply, forcing the transplant community to decide who should get available life-saving organs. At the end of 1991, over 1,500 people were on waiting lists seeking cadaver livers and over 2,000 were seeking hearts'; of those patients, 9.9 percent awaiting livers and 16.7 percent awaiting hearts were removed from the waiting lists because they died before transplant organs be came available. 1 Because of this unavoidable shortage, the transplant community has had to literally decide—by choosing who gets an organ—who lives or dies.

Despite the great amount of attention focused on transplant allocation, few have remarked at length about the special issues raised by the allocation of organs to retransplant candidates. This made some sense initially, both because retransplantation was a rapidly progressing field, with uncertain efficacy in many patient groups, and because many were hopeful that enough organs could be procured to reduce the scarcity of available organs. 2,3,4,5 But this inattention is no longer justifiable. The shortage of cadaveric transplant organs has grown with time rather than decreased.' Meanwhile, retransplantation has become a large part of transplant practice, accounting for 20 percent of all liver transplants (written communication, Steven Belle, PhD, United Network for Organ Sharing [UNOS]/ University of Pittsburgh [ Pa] Liver Transplant Registry, December 14, 1992) and 10 percent of heart transplants, excluding heart-lung transplants (written communication, Tim Breen,

Originally published in JAMA 270, no. 20 ( November 24, 1993): 2469-74.


Notes for this page

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Cite this page

Cited page

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited page

Bookmark this page
The Ethics of Organ Transplants: The Current Debate
Table of contents

Table of contents



Text size Smaller Larger
Search within

Search within this book

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen
/ 350

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?