NDT Advance Access originally published online on May 26, 2005
Nephrology Dialysis Transplantation 2005 20(7):1303-1306; doi:10.1093/ndt/gfh911
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The question of organ procurement: beyond charity
Faculty of Medicine Paris-Descartes, Department of Transplantation, Hôpital Necker, Paris, France
Correspondence and offprint requests to: Henri Kreis, MD, Professor of Nephrology, Consultant, Faculty of Medicine Paris-Descartes, Department of Transplantation, Hôpital Necker, 149, rue de Sèvres, 75743 Paris Cedex 15, France. Email: kreis{at}necker.fr
Over the past 15 years, the shortage of organs for transplantation has worsened. This has forced clinicians to review alternative approaches to organ procurement. These new approaches, however, may have serious implications both for patients and for society as a whole. Ever since the first cadaver organs were used for transplantation, organ procurement has relied on the altruism and goodwill of donors. It now appears that this 40-year-old policy is proving unsuccessful. In order to increase the availability of suitable organs and allow cadaver organ transplantation to continue, it is time to consider new strategies other than donation. Among all the potential methods of organ procurement, including donation, abandonment, sale and societal appropriation, only the latter has never been ethically discussed or implemented. This article considers a variant of this approach defined as conditional societal appropriation as an ethically acceptable possibility. It has the potential to become the principle method for obtaining the necessary organs for transplantation in the near future.
Keywords: donation; ethics; organ procurement
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