"Living Apart Together" - Do the two co-existing systems - Cadaveric and living donation - Live in harmony?

Medard Hilhorst

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Cadaveric donor transplantation and living donor transplantation exist side-by-side. Both practices contribute to the alleviation of organ need. They provide us with two separate moral schemes. Is it rational to keep them apart? The cadaveric system is strictly organized along impartial lines, while the living system is inherently partial and local. The ethical justification of this partial scheme seems to be that it merely supplements the cadaveric scheme: partial transplantations do not come at the expense of impartiality, but in fact significantly reduce the waiting time on the cadaveric list. This seemingly peaceful co-existence is challenged by new initiatives, among them Living Donation List Exchange (LDLE), but also the LifeSharers' initiative, leading to practices that undermine impartiality. Should we bemoan this fact, or should we move on towards a new balance in the relationship between cadaveric and living transplantation practices; towards a new moral weighing of impartial and partial values? I argue that we have good ethical reasons - not only utilitarian ones - for giving the value of partiality a more prominent place in our policies.
Original languageUndefined/Unknown
Pages (from-to)132-139
Number of pages8
JournalOrgan Transplantation: Ethical, Legal and Psychosocial Aspects
Publication statusPublished - 2008
Externally publishedYes

Research programs

  • EMC OR-01-74-01

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