A forum in the 15 June edition of the journal Transplantation has presented commentaries on the controversial issue of conditional organ donation.
The forum features summaries of six recent cases illustrating the complex issues involved in conditional organ donation. Invited statements from patient groups, professional organisations, and medical ethicists lend insights into the principles followed in making these difficult ethical decisions.
In the United Kingdom, national debate was stirred by a 1999 case in which the family of a deceased donor stipulated that the organs could be used for transplantation but only in white recipients. In response, the government and professional organisations issued an “unequivocal” policy against such conditional organ donation: “Organs must not be accepted if conditions about the recipient are attached.”
However, new questions were raised when the family of a potential donor agreed to donate only if the deceased man’s child who happened to have a congenital liver disease received the liver. Although this was clearly contrary to the rule, an exception was made because of the close family relationship between the donor and recipient.
Other scenarios illustrate further dilemmas. For example, one potential donor’s family stipulated that the liver could not be used in a patient with alcoholic liver disease. The forum contributors agree that excluding patients with specific causes of disease should not be permitted since the stipulation on the liver recipient is unacceptable, none of the donor’s organs should be accepted.
Meanwhile, the forum also includes an opinion poll showing that a substantial proportion of the British public considers it acceptable to exclude patients with alcoholic liver disease. In contrast, a large majority feel that racial restrictions are unacceptable.