Health Care Analysis

, Volume 8, Issue 3, pp 279–295 | Cite as

Improving Organ Retrieval Rates: Various Proposals and Their Ethical Validity

  • Eike-Henner W. Kluge


The current global shortage of organs has prompted aseries of proposals for improving organ retrievalrates. They include preferred recipient status forregistered organ donors, payment for organs, presumedconsent and required response. This paper examinesthe tenability of these proposals and points out theirshortcomings. Taking the Canadian situation as anexample, it argues further that the shortage isexacerbated by unethical and essentially illegalretrieval protocols that flout the law of informedconsent. It is suggested that before any redrafting oflaws and regulations is undertaken, these protocolsshould be revised.

organ donation organ sale presumed consent retrieval protocols required response transplantation 


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  1. Barnett, A.H., Blair, R.C. and Kaserman, D.L. (1992) Improving Organ Donation: Compensation Versus Markets. Inquiry 29, 372–378.Google Scholar
  2. Burdick, J.F., Capron, A.M., Delmonico, F.L., Ravenscraft, M.D., Reckard, C.R. and Shapiro, M., (1993) Preferred Status for Organ Donors: A Report of the UNOS Ethics Subcommittee.Google Scholar
  3. DeJong, Drachman, Gortmaker et al. (1995) Options for Increasing Organ Donation: The Potential Role of Financial Incentives, Standardized Hospital Procedures, and Public Education to Promote Family Discussion. The Milbank Quarterly 73(3), 463–479.Google Scholar
  4. Dukeminier, J. and Sanders, D. (1968) Organ Transplantation: A Proposal for Routine Salvaging of Cadaver Organs. New England Journal of Medicine 279, 413–419.Google Scholar
  5. Evans, R.W. (1993) Organ Procurement Expenditures and the Role of Financial Incentives. JAMA (June 23-30) 269(24), 3113–3118.Google Scholar
  6. Gunderson, S. and Taft, F. (1995) Organ Shortage Makes Payment Tempting. Nephrol News Issues (Aug) 9(8), 23, 27.Google Scholar
  7. Hansmann H. (1989) The Economics and Ethics of Markets for Human Organs. J Health Polit Policy Law (Spring) 14(1), 57–85.Google Scholar
  8. Kahan, B.D.: Rewarded Gifting - Pro and Con: Bringing the Arguments into Focus. Transplantation and Immunology Letter 8, 3-10.Google Scholar
  9. Kaplan, A.L. (1983) Organ Transplants: The Costs of Success, An Argument for Presumed Consent and Oversight. Hastings Center Report 13, 23–32.Google Scholar
  10. Kasiske, B.L., London, W. and Ellison, M.D. (1998) Race and Socioeconomic Factors Influencing Early Placement on the Kidney Transplant Waiting List. J Am Soc Nephrol (Nov) 9(11), 2142–2147.Google Scholar
  11. Kittur, D.S., Hogan, M.M., Thukral, V.K., McCaw, L.J. and Alexander, J.W. (1991) Incentives for Organ Donation. Lancet 338, 1441–1443.Google Scholar
  12. Kleinman, I. and Lowy, F.H. (1997) Ethical Considerations in Living Organ Donatian and a New Approach: An Advance-Directive Organ Registry. Arch Intern Med 152, 1484–1488.Google Scholar
  13. Mates, A.J. and Keith, F.J. (1984) Presumed Consent for Organ Retrieval. Theoretical Medicine 5, 155–166.Google Scholar
  14. Person, W.N. (1987) Refining the Law of Organ Donation: Lessons from the French Law of Presumed Consented. New York University Journal of International Law and Politics 19, 1013–1032.Google Scholar
  15. Peters, T.G. (1991) Life or Death: The Issue of Payment in Cadaveric Organ Donation. JAMA 265(10):1302–1305.Google Scholar
  16. Reels, L. et al. (1990) Effect of a Presumed Consent Law on Organ Retrieval in Belgium. Transplantation Proceedings 22, 2078–2079.Google Scholar
  17. Sob, P. and Lim, S.M.L. (1992) Opting-Out Law: A Model for Asia - The Singapore Experience. Transplantation Proceedings 24, 1337.Google Scholar
  18. Sob, P., Dyer, T. and Lim, S.M.L. (1992) Profile of an Asian ‘Opting-Out’ System - The Institutional and Legal Arrangements in Singapore. Transplantation Proceedings 24, 323–1324.Google Scholar
  19. Spital, A. (1991) The Shortage of Organs for Transplantation. New England Journal of Medicine 325, 1243–1246.Google Scholar
  20. Starzl, T.E. (1984) Implied Consent for Cadaveric Organ Donations. Journal of the American Medical Association 251, 1592.Google Scholar
  21. Titmuss, R.M. (1970) The Gift Relationship: From Human Blood to Social Policy. London: Allen and Unwin.Google Scholar
  22. Transplantation and Immunology Letter, Vol. VIII, No. 1, March 1992.Google Scholar
  23. United Network for Organ Sharing (1992) Ad Hoc Donations Committee White Paper: Alternative Methods. Organ Donation Study: Executive Summary of a National Survey. National Kidney Foundation.Google Scholar
  24. United Network for Organ Sharing (1993) Presumed Consent: An Evaluation of the Ethics of Presumed Consent and a Proposal Based on Required Response.Google Scholar
  25. Veatch, R.M. (1991) Routine Inquiry About Organ Donation - An Alternative to Presumed Consented. The New England Journal of Medicine 325, 1246–1249.Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Eike-Henner W. Kluge
    • 1
  1. 1.Department of PhilosophyUniversity of VictoriaCanada

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