Ethical considerations in living organ donation and a new approach. An Advance-Directive Organ Registry
I. Kleinman and F. H. Lowy
Centre for Bioethics, University of Toronto, Ontario, Canada.
Living organ donation should be recognized as an ethical compromise to the
principle of nonmaleficence (doing no harm), given the risks healthy donors
are allowed to assume. Living organ donation should be reserved for
situations in which there is no acceptable alternative. Increasing the
availability of cadaveric organs is most desirable, since it would decrease
(although probably not eliminate) the need for living organ transplantation
and would provide organs (ie, hearts) that could not otherwise be obtained.
We propose the development of an incentive-based Advance-Directive Organ
Registry, in which all adults are encouraged to register their advance
directive regarding organ donations. Those individuals agreeing to permit
usable organs to be taken at the time of death would receive priority for
organs generated by the program, should a transplant become necessary when
there is a shortage of organs. The proposed Advance-Directive Organ
Registry is firmly founded on the principles of autonomy, beneficence, and
justice.
