Donor Liver Transplantation
R. W. Strong and S. V Lynch
The quest to save life and stave off death are traditional goals in medicine. The scientific and clinical endeavors in transplantation in the last half of this century have seen these goals come to fruition for many patients. Commensurate with these milestones "a new dimension of urgency and finality" 1 was born. There is little wonder that the law of the land and the ethical issues lag behind the rapid advances and that the pace-setting activities by the few have outstripped comprehension and acceptance by the many.
Over many centuries the Western practice of medicine has been committed to the Hippocratic principle, to act in the patient's best medical interest, irrespective of outside influences. This doctor-patient relationship has been eloquently enunciated by Starzl. 2 "It is doubtful if many doctors who actually care for the sick and the infirm, plan their actions on the basis of the predicted effect upon society. Instead, the dominant tradition is for the physician to provide the best care of which he is capable for those who either seek his services or are assigned to his responsibility; by and large this is done without regard for the conceivably broader issue of whether treatment is justifiable on social grounds. His reasons may include pride, altruism, compassion, curiosity, a spirit of competition, even avarice, or a combination of all these things. The foregoing viewpoint is a narrow one, but there is no reason to believe that it should be abandoned in the face of advancing technocracy. It has shielded the ill from the caprices and moral judgements of other men through centuries of evolving philosophical, religious, and legal doctrines. It has placed the concept of the sanctity of human life on a practical foundation since the respon____________________