Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jun 24, 2015; 5(2): 44-51
Published online Jun 24, 2015. doi: 10.5500/wjt.v5.i2.44
Philosophy of organ donation: Review of ethical facets
Aparna R Dalal
Aparna R Dalal, Icahn School of Medicine at Mount Sinai, NY 10029, United States
Author contributions: Dalal AR authored the paper.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Aparna R Dalal, MD, Assistant Professor in Anesthesiology, Icahn School of Medicine at Mount Sinai, 1428 Madison Avenue, NY 10029, United States. aparna.dalal@mssm.edu
Telephone: +1-216-2722545 Fax: +1-206-4864610
Received: August 21, 2014
Peer-review started: August 21, 2014
First decision: September 16, 2014
Revised: February 6, 2015
Accepted: March 16, 2015
Article in press: March 18, 2015
Published online: June 24, 2015
Abstract

Transplantation ethics is a philosophy that incorporates systematizing, defending and advocating concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews several fundamental ethical principles, prevailing organ donation consent laws, incentives and policies related to the field of transplantation. The Ethical and Policy Considerations in Organ Donation after Circulatory Determination of Death outline criteria for death and organ retrieval. Presumed consent laws prevalent mostly in European countries maintain that the default choice of an individual would be to donate organs unless opted otherwise. Explicit consent laws require organ donation to be proactively affirmed with state registries. The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation have also been reviewed in detail.

Keywords: Transplantation, Ethics, Organ donation, Incentives for donation, Organ trade, Presumed and explicit consent

Core tip: Transplantation ethics is philosophy that involves systematizing, defending and recommending concepts of right and wrong conduct related to organ donation. As the demand for organs increases, it is essential for the society to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical. In the field of organ transplantation, role of altruism and medical ethics values are significant to the welfare of the society. This article reviews the fundamental ethical principles to prevailing organ donation consent laws, incentives and policies.