Solid Organ Donation between Strangers

Matas A.J. , “Nondirected Donation of Kidneys from Living Donors,” N. Engl. J. Med., 343, (2000): 433–36.

Lee H.K. , “Uncle Donates Kidney In Teen's Third Transplant; Inmate Father's Attempt to Save Daughter Failed,” The San Francisco Chronicle, April 8, 1999,): at A15.

Id.

Galashan S. , “Baby Camilo Departs for New York: While Liver Donors Wait in Canada for the Call, Surgeons are to Assess Boy's Condition,” Vancouver Sun, March 21, 2001,): at B1.

Id.

Id.

Steinkohl V.S. , “Nach der Nierenentnahme Spender Jochem Hoyer will Anst abbauen,” Sueddeutscher Zeitung, July 27, 1996 at section: Muenchen.

Grady D. , “The New Organ Donors are Living Strangers,” The New York Times, September 20, 1999,): at A1.

Matas , supra note 1.

Id. at 434.

See Feinberg J. , Harm to Others. Volume 1: The Moral Limits of the Criminal Law. (New York: Oxford University Press, 1984): at 74–75.

Elliott C. , “Doing Harm: Living Organ Donors, Clinical Research and the Tenth Man,” Journal of Medical Ethics, 21 (1995): 91–96, at 95.

See, for example, Simmons R.G. Klein S.D. Simmons R.L. , Gift of Life: The Social and Psychological Impact of Organ Transplantation (New York: Wiley, 1977): at 176–87;.

Johnson E.M. , “Long Term Follow-up of Living Kidney Donors: Quality of Life After Donation,” Transplantation, 67, (1999): 717–21.

Capron A.M. , “Reexamining Organ Transplantation,” JAMA 285, (2001): 334–36.

Elliott , supra note 12, at 95.

Currently there is no consensus as to what constitutes “significant” risk. Kasiske and Bia document the wide variability of exclusion criteria for living kidney donors.

See Kasiske B.L. Bia M.J. , “The Evaluation and Selection of Living Kidney Donors,” American Journal of Kidney Diseases, 26 (1995): 387–98, at 394.

In June 2000, over one hundred representatives of the transplant community (physicians, nurses, ethicists, psychologists, lawyers, scientists, social workers, transplant recipients, and living donors) convened for a workshop on living solid organ donors. They issued a report in JAMA in December 2000.

The report outlines areas of consensus and areas of controversy. It does not provide specific criteria for the exclusion or inclusion of live donors but describes what factors need to be considered for the donor to be medically and psychologically suitable. It also refers to other documents that provide some specific guidelines for particular organs. See The Authors for the Live Organ Donor Consensus Group, “Consensus Statement on the Live Organ Donor,” JAMA 284 (2000): 2919–26.

Spital A. Spital M. , “Living Kidney Donation: Attitudes Outside the Transplant Center,” Archives of Internal Medicine 148, (1988): 1077–80.

Press Release, National Kidney Foundation (June 22, 2000), available at <http://www.kidney.org/general/news/strangers.cfm> (last visited October 16, 2002).

Matas , supra note 1, at 434.

Id.

UNOS has an ethics committee comprised of both ethicists and physicians. This committee has examined a variety of ethical and policy issues including the question of how priority should be given on the transplant wait list, whether alcoholics should be listed for liver transplantation, and if so, whether or not they should be given lower priority. Some of these discussions are described by Robert Veatch, a medical ethicist who has served three terms on the UNOS ethics committee.

See Veatch R.M. , Transplantation Ethics (Washington, D.C.: Georgetown University Press, 2000).

For a full discussion of directed donations, see id. at 303–04, and 388–411.

Matas , supra note 1, at 435.

Gridelli B. Remuzz G. , “Strategies for Making More Organs Available for Transplantation.” N. Engl. J. Med., 343 (2000): 404–10, at 407.

Levinsky N.G. , “Organ Donation by Unrelated Donors,” N. Engl. J. Med., 343 (2000): 430–32 at 431.

Matas , supra note 1, at 436.

See text, infra note 31–33.

This may or may not be the case. As the case unfolded, Jerry Ewen, Camilo's father admitted to knowing the donor, and in fact, it was reported that she had been in the process of a workup in Canada when “she became unhappy with the ‘grueling and undermining interrogation that felt dehumanizing and made her feel like a criminal,’ says the family's statement.”

See The Canadian Press, “Father Admitted Lying About Son's Living Organ Donor: Ailing Infant's Liver Transplant Called a Success,” The Ottawa Citizen, April 7, 2001, at A3

citing the family's statement. This created much controversy because it meant that the transplant could have been performed in Canada and paid for by the Canadian health system. Camilo's parents, instead, sought altruistic donations, and had collected about $240,000. The Variety Club of British Columbia had collected $140,000. It offered to return all the money it raised to help the family when these facts came to light. See Galashan S. , “Public Funeral Planned for Baby Camilo: Six-Month-Old Died After U.S. Transplant Surgery,” The Vancouver Sun, April 10, 2001,): at A1.

Elliott , supra note 12, at 95.

Mazzolini J. , “Guidelines Sought for Taking Organs from Patients Not Declared Brain-Dead.” The Plain Dealer (Cleveland), Dec. 20, 1997, at 1A.

Matas , supra note 1 at 433.

Ross L.F. , “Should All Living Donors Be Treated Equally?,” Transplantation, 74 (2002): 418–21.

Glannon W. Ross L.F. , “Do Genetic Relationships Create Moral Obligations in Transplantation?,” Cambridge Quarterly of Healthcare Ethics, 11 (2002): 153–59.

See text, supra notes 26–28.

Matas , supra note 1, at 433.

Id. at 435.

Neuberger J. Ubel P.A. , “Finding a Place for Public Preferences in Liver Allocation Decisions,” Transplantation, 70 (2000): 1411–13;.

Ratcliffe J. , “Public Preferences for the Allocation of Donor Liver Grafts for Transplantation,” Health Economics, 9 (2000): 137–48.

Ubel P.A. , “Transplantation in Alcoholics: Separating Prognosis and Responsibility from Social Biases,” Liver Transplantation and Surgery, 3 (1997): 343–46.

Peters T.G. , “Organ Donors and Nondonors. An American Dilemma,” Archives of Internal Medicine, 156 (1996): 2419–24.

This case described a man who was a member of the Ku Klux Klan and whose family gave permission for organ procurement provided that the recipient was Caucasian. See also Norton C. Herbert I. , “How a Dead Man Provoked an Ethical Dilemma that has Convulsed the NHS,” The Independent (London), July 8, 1999, at 3, in

which the family also requested that the recipient be Caucasian. Both decisions sparked heavy public and professional criticism.

Levinsky , supra note 24, at 431.

Id.

Id.

Rapaport F.T. , “The Case for a Living Emotionally Related International Kidney Donor Exchange Registry,” Transplantation Proceedings, vol. 18, no. 3, Supplement 2 (1986): 5–9.

See Stolberg S.G. , “Organ Transplant Panel Urges a Broad Sharing of Livers,” The New York Times, July 21, 1999,): at A14.

The Institute of Medicine report was published in September 1999 (see Committee on Organ Procurement and Transplantation Policy, Institute of Medicine, Organ Procurement and Transplantation: Assessing Current Policies and the Potential Impact of the DHHS Final Rule (Washington, D.C.: National Academy Press, 1999)). Final rules were published on October 20, 1999 (see 64 Fed. Reg. 56650, Rules and Regulations, Department of Health and Human Services, Health Resources and Services Administration, 42 C.F.R. pt. 121, Organ Procurement and Transplantation Network, Part VI).