Ethical Dilemma in Organ Allocation

Transplantation is an efficient and effective life-prolonging treatment.  for the failure of organs. In the past years, the demand for transplantation has increased hence leading to the shortage in organ supply. Furthermore, the number of individuals willing to donate organs seems to have remained constant in the past years. In this regard, transplant programs are facing the challenge of developing a framework that can help determine the urgency of receiving organ transplant. The most appropriate framework for solving ethical dilemmas in organ allocation should involve taking into consideration the three basic principles of ethics, which are justice, utility and the respect for individuals in line with the situational model that emphasizes  the aspect of love.


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The Values Related to Transplantation

Assessing the people on the waiting list in regard to the organ transplantation is the key prerequisite towards organ allocation. In this case, one ought to consideration various aspects including those of “justice”, “utility” as well as “respect for persons” with a view of achieving equitable outcomes in organs allocation for the purposes of transplantation. When emphasizing the “utility” aspect, the allocation of organs ought to maximize the overall expected net amount of good., The leading principles applied here are those of beneficence and non-maleficence.  They mean doing good and doing no harm respectively. In regard to the value of justice, the National Organ Transplant Act (NOTA) supports equitable access to organ transplantation for all patients. It also stands for the fair selection of waiting lists’ patients apart from ensuring fair allocation of organs. As far as the notion of “respect for persons” is concerned, healthcare providers ought to treat human beings with respect. Therefore, honesty and fidelity to the commitments made ought to be upheld as a moral imperative. Moreover, this notion provides for respect to autonomy. It means that the allocation of organs should involve the duty of respecting the donor’s decision, the right of patients to reject organ transplantation, ensuring transparency in the processes involved.  Transparency in the issues related to organ allocation  promotes the ability of the stakeholders to make informed decisions.

A Model for the Framework

The best model for the framework is the one that maximizes the medical good amount, simultaneously leading to the just distribution of organs and  providing the respect for individuals such as the respect for autonomous decisions. In this regard, the most appropriate model one can use is the situational model. The model provides for the morality of an act if the act leads to the creation of the greatest amount of love. Therefore, by using the situational model, the notions of utility, justice and respect for individuals ought to be specifically applied under particular conditions. This therefore implies that medical personnel have to make appropriate decisions  to ensure that the three principles – utility, justice and respect for individuals – are incorporated in the allocation of organs without leading to the probability of the occurrence of conflict in the application of the principles.

Solving the Ethical Dilemma

Solving the ethical dilemma should then follow the application of the model mentioned in the discussion provided above. Thus, while solving the ethical dilemma in the case of the allocation of organs, one has to rank the three ethical principles discussed above. The ranking of the principles will lead to making conclusions about the right approach to be taken in the allocation of organs while balancing the principles. For instance, in the situation whereby increasing utility might lead to the violation of the principles of justice and respect to individuals, moderation has to be incorporated to promote balance.

Additionally, another approach that can be used in solving the ethical dilemma is the focus on the principles of prime facie at the same moment while balancing them in a manner that leads to the making of a single conclusion. It leads to the integration of all the principles that are relevant to the most appropriate degree. This approach provides room for the presentation of problems as an individual aims at deciding the relative weight of granting each principle in a particular situation or rather condition and the manner in which the weight might be manifested practically. Hence, from the approaches mentioned above, when the principles tend to conflict with each other, the policy that ought to be taken in solving the ethical dilemma in organ allocation should lead to the achievement of the aims of transplantation. In light of this, there is the minimization of the infringement of a particular principle with a view of achieving the good. The policies chosen should then be applied in a very transparent manner in order to benefit all the stakeholders involved.


In conclusion, an assessment that is equitable for people on a waiting list in regard to transplantation is the key foundation for fair organ allocation. Therefore, utility, justice as well as the respect to persons are the key ethical principles that lead to the creation of a framework that promotes the equitable allocation of the scarce organs for transplant. Consequently, an appropriate model ought to be identified in order to ensure that there is a balance among the above mentioned principles in order to promote good outcomes. In this respect, a good policy for the allocation of organs for the process of transplantation has to incorporate the three principles of ethics besides ensuring the balance of the principles in their application to eliminate chances of the occurrence of conflicts between the principles.

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