During the last ten years, the demand for organs in the United States has been far more than the supply and this has created a large waiting list of patients for getting the organs. Despite the efforts to meet the growing demand an unknown number of patients die each year, being unable to get the life-saving organs. This raises the question that how the allocation of this scarce resource can be regulated.
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On the matter of allocating this resource there are two ethical considerations weigh. They are:
- commutative justice and
- distributive justice.
“Commutative justice is about rendering unto this patient what is his or her due, in this case, what he or she needs; it is distinguished from distributive justice, which is about how benefits are distributed in a group or groups of patients. “
Though it is widely acknowledged that medical decisions affecting the patient-physician relationship in general is to be based on the commutative principle when the question of organ transplants come the commentators take a stand that it is both commutative and distributive justice that should be considered in matters involving organ transplants. They hold this view because of the scarcity of the organs available for transplant. From the perspective of distributive justice, every decision about an individual is taken with the implications that decision can have on the group (Davis and Wolitz).
This situation gives rise to another question as to whether the gap between the demand and supply of organ making it a scarce resource justifies the intrusion of distributive justice into a patient-physician relationship. If there is an answer in affirmative for this question then the distributive justice affects the way a particular doctor serves his/her patient. It can be argued that just because of the scarcity of the organs we cannot blame a doctor who feels that considering the circumstances of the case, it is most beneficial to the patient he pledged to save to get the organ transplanted in preference to others waiting to get it.
This is the principle behind the commutative justice. However, from a distributive justice point of view the action of the doctor to conduct the transplant with the organ obtained cutting the line may not be ethical, since such a decision affects the group.
Action of Krampitz
The action of Krampitz to advertise in the newspaper and TV shows to get the organ donated could have helped him successfully acquire a liver for transplant. However his action, it is alleged that has undermined the whole distributions system for organs in practice since 1986. One might argue that it was an effective campaign by Krampitz that it saved his life. However, he is criticized for resorting to advertisements as it meant that he got the liver by cutting the line, which is unethical (Fairness).
The list of people in need of organs is compiled by “United Network for Organ Sharing” a quasi body, and the list of people in need of the organs is created so that every patient looking for a life-saving organ is given a fair chance to receive it. The system for distributing organs uses a number of criteria for allocating the scarce organs and with the present set of criteria Krampitz would not have got a liver. He used a loophole in the system and got the organ which may be ethical according to commutative justice but definitely is not so under distributive justice (Caplan).
Caplan, Arthur. Cutting in Line for Organ Transplant. 2004. Web.
Davis, Dan and Rebecca Wolitz. The Ethics of Organ Allocation. 2009. Web.
Fairness. Cutting in line for organ transplants: Texas man’s efforts to get liver undermine system. 2009. Web.