Abstract
Bioethics has entered a new era: as many commentators
have noted, the familiar mantra of autonomy, beneficence,
nonmaleficence, and justice has proven to be an overly simplistic
framework for understanding problems that arise in modern medicine,
particularly at the intersection of public policy and individual
preferences. A tradition of liberal pluralism grounds respect
for individual preferences and affirmation of competing conceptions
of the good. But we struggle to maintain (or at times explicitly
reject) this tradition in the face of individual preferences
that we find distasteful, suspect, or even repugnant, especially
where the broader social good or respect for equality is at
stake. Directed donation presents us with such a dilemma: can
we uphold the right of self-determination through respect of
individual preferences regarding disposition of transplantable
organs while at the same time maintaining an allocation system
that reflects values of equity and justice claimed to underlie
the socially negotiated practice of transplantation? Or are some
preferences simply to be deemed unethical and not respected, even
if that leads to a reduction in the number of transplantable organs
available and to an apparent disregard for the autonomous decisions
of the recently deceased?
Publisher
Cambridge University Press (CUP)
Subject
Health Policy,Issues, ethics and legal aspects,Health(social science)
Cited by
21 articles.
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