Chapter 5: Organ and Tissue Transplantation: A Case Study in Distributive Justice
INTRODUCTION Produced in 1906, George Bernard Shaw’s play The Doctor’s Dilemma is as fresh a statement of the current medical issue of resource allocation as it was when ﬁrst produced. The dilemma for Shaw’s principal character, Dr. Sir Colenso Ridgeon, was to decide—between two patients—which was so deserving as to receive a new wonder drug, designed to cure consumption, that he had developed. One patient was an artist and “dishonest scoundrel” but married to a most attractive woman named Jennifer. The other patient was an honest doctor working with the poor. Initially, Ridgeon decided to give the treatment to the physician, but changed his mind, subsequently, because he was smitten by Jennifer and hoped to curry “favor” with her by assisting her husband. Reversing himself largely because three of his colleagues determined her husband to be a dishonest sociopath, Ridgeon treated the honest doctor and referred the artist-husband of Jennifer to another colleague— condemning him, as such, to death. He rationalized his choice by concluding, “having patients die is a rational part of being a doctor.”1 Today, a similar rationalization is made for those Americans who must die prematurely simply because no organ transplants are available to them. On 3 December 2007, there were over 97 800 candidates for organ transplants— with a new name being added every 10 minutes.2 From January 2007 to 30 November 2007, 21 401 transplants were performed from 10 847 donors.3 These statistics are indeed quite sobering for they conﬁrm what...
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