Rationing Lung Transplants - Procedural Fairness in Allocation and Appeals

From the Department of Occupational Therapy and the Lab for Research on Ethics, Aging, and Community Health (REACH Lab), Tufts University, Medford, MA (K.L.)
New England Journal of Medicine (Impact Factor: 55.87). 07/2013; 369(7). DOI: 10.1056/NEJMp1307792
Source: PubMed


Organ transplantation requires explicit rationing and relies on public trust and altruism to sustain the organ supply. The well-publicized cases of two pediatric candidates for lung transplants have shaken the transplant community with emergency legal injunctions arguing that current lung-allocation policy is "arbitrary and capricious." Although the resulting transplantation seemingly provided an uplifting conclusion to an emotional public debate, this precedent may open the floodgates to litigation from patients seeking to improve their chances of obtaining organs. These cases questioned the potential disadvantaging of children and the procedural fairness in lung allocation. But legal appeals exacerbate inequities and undercut public . . .

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