Few contemporary issues question the nature of life and death, families and communities, altruism and self-interest, and individual rights and public good as dramatically as does organ donation and transplantation. Transplantation raises profound and intriguing concerns about the interplay of medical needs, state authority, and bodily integrity. Although advances in medical technology and the development of immunosuppressant drugs have made transplantation an almost routine procedure in many parts of the world, the actual availability of transplantable organs remains inadequate to the need. Accordingly, various strategies and policies are in force to increase the supply of organs. In this edited volume, Bethany Spielman includes selected papers from a 1995 conference co-sponsored by the Department of Medical Humanities of the Southern Illinois University School of Medicine and the Live and Learn Organ Donation Awareness Program of the Illinois Secretary of State. Seventeen experts from the fields of bioethics, medicine, law, history, philosophy and public policy consider questions integral to the foundations and operations of organ donation in the 1990s. To what extent is policy guided by law, cultural notions of gift giving, scientific facts, or political interests? How should organs be obtained and from whom? What should be the role of financial incentives? Do existing frameworks and protocols in medical centres and surgical suites sufficiently protect and respect living and cadaver donors? Can donations be increased to meet growing demand? Is there a right to refuse donation? The essays explore a range of specific issues: Third World violation of rights and the "theft" of organs, proposed and proven remedies for the shortage of organs, the unique ethical issues relating to donations by children, the rescinded American Medical Association decision to approve harvesting of organs from anencephalic infants, and apparent inequities in national and global allocation.
