Selected Issues > Organ Transplantation
Organ Transplantation

organ translant imageNearly 100,000 people in the United States are on waiting lists for kidneys, hearts, livers, lungs, and other organs. Many of these people die each day because the demand for organs greatly exceeds the supply, and the disparity is widening.

Throughout its history, the Hastings Center has played a prominent role in developing ethically sound strategies for expanding the organ supply, including recommendations that lead all 50 states to require hospital representatives to discuss organ donation with families of patients declared brain dead. But despite these laws and other strategies, such as organ donation cards, the organ shortage remains. Some people favor changing the federal law to permit people to buy and sell organs. But this approach is fraught with ethical problems, including the risk that only the desperately poor would be induced—and possibly coerced--to sell their body parts.

From the Hastings Center

Bioethics Forum

Can Social Media Increase Transplant Donation and Save Lives?

Blair L. Sadler and Alfred M. Sadler, Jr.

Bioethics Forum

Donate an Organ, Get Out of Jail

Kathleen M. Boozang

1999 November-December

The Dead Donor Rule

By John Robertson

The scarcity of vital organs has prompted several calls to either modify the dead donor rule or interpret it more broadly.  Given its symbolic importance, however, the rule should be changed only cautiously.

2009 May-June

Exchanging One Hardship for Another

By Lesley A. Sharp
In this issue, Farhat Moazam and colleagues offer a complex and nuanced study of the postsurgical consequences of kidney vending in Pakistan’s Punjab region, providing a comprehensive response to highly polarized debates over the commercialization of “fresh” body parts. By journeying beyond the hospital and into vendors’ communities, the research generates troubling findings. All vendors endure strenuous manual labor; simple nephrological tests reveal evidence of kidney disease or failure. Clinical dangers are compounded by anxiety, depression, self-loathing, diminished self-worth, and suicidal tendencies. Vendors are marginalized socially, too—considered “half a person” once they’ve lost a kidney.

2009 May-June

Conversations with Kidney Vendors in Pakistan: An Ethnographic Study

By Farhat Moazam, Riffat Moazam Zaman, and Aamir M. Jafarey
The growing concern about the shortage of kidneys available for transplantation has led some physicians, economists, and bioethicists to call for monetary inducements and “regulated” organ markets as a way of expanding the number of kidneys obtained from living, unrelated individuals. In contrast, those opposed to the idea of organ sales believe that such practices lead to exploitation of the most vulnerable people in society for the benefit of the privileged. Missing from the literature is in-depth sociological work on the vendors—the men and women who opt to undergo nephrectomy for money—and the on-the-ground realities that frame their decision. Very little is known about the sociological and psychological effects on vendors and on the families and societies they belong to when faced with a situation in which the only way to address financial difficulties is to sell a kidney.

Our aim is to turn the light on those who sell kidneys. Our research provides a “thick” description of the lives of kidney vendors and their families in Pakistan, people who stand at the center of organ commerce and yet have remained largely invisible. We attempt to open a window into their lives, to capture through their narratives what it “means” to them and their families when circumstances compel them to sell a kidney, and the ways in which this act affects connected existences.


Infant Heart Transplant Controversy Highlights Importance of Dead Donor Rule

Transplantation After Cardiac Death Using a procedure known as donation after cardiac death (DCD), Denver surgeons recovered hearts for transplantation from three dying newborns soon after the hearts had stopped beating—after 3 minutes in the


BIOETHICS RESPONDER: Infant heart transplant controversy highlights importance of Dead Donor Rule

Heart Transplantation After Cardiac Death Contact Mary Crowley Phone 845 424 4040 The News Using a procedure known as donation after cardiac death (DCD), Denver surgeons recovered hearts for transplantation from three dying newborns soon after the hearts

Hastings Center Report

Moving the Womb

By Arthur L. Caplan, Constance Perry, Lauren A. Plante, Joseph Saloma, and Frances R. Batzer
Recently, a team of physicians at the New York Downtown Hospital announced that they had received approval from their institutional review board to attempt the first uterus transplant in the world from a cadaver donor. Unlike most organ transplants, the point of a uterus transplant would not be to save a life. Uterus transplants would be attempted only to improve the recipient’s quality of life: they would allow her to give birth. This very different risk-benefit calculation raises many ethical questions.

Hastings Center Report

We Need a Registry of Living Kidney Donors

By Lainie Friedman Ross, Mark Siegler, and J. Richard Thistlethwaite, Jr.
On September 19, 2007, the board of the United Network for Organ Sharing deferred a decision to adopt uniform medical guidelines to protect the safety of living kidney donors. There is disagreement about what the guidelines should say, primarily because there is a lack of definitive data about the long-term health outcomes for living organ donors.