n the national waiting list for organ transplantation. If all the potential organ donors were donated, needs would be met, however, each year approximately 5,000 human organs that are medically suited for transplantation, are not donated. Ethical imbalances include the rights of the general public versus the medical benefits to a specific population (DePalma & Townsend, pp. 2-3). Two questions dominate discussions of ethics and public policy in organ transplantation, how to increase supply of organs, and how to do it in an effective, efficient, and just way. There is a need to increase the supply of organs to save lives or enhance the quality of lives, and societal efforts to increase the supply needs to remain within ethical boundaries. The goal of increasing supply will not justify every effective means of doing so. Terms such as ethical acceptability and ethical preferability are discussed; laws may be ethically acceptable however they may not be ethically preferable if they do not promote communal altruism (Childress, 1996, p. 9).
The cadaver has rights; the Uniform Anatomical Gift Act (UAGA) established a donation framework for the transfer of organs. Within the framework, competent individuals have the right to determine what will be done with their organs after they die. In the absence of this expression, the family legally can decide regarding donation of organs. Individuals rarely sign donor cards and families are the primary decision makers. UAGA provides a blanket of immunity from civil and criminal liability for good faith actions on the basis of signed donor cards. Ethical reasons for this include concerns not to increase the family's trauma by overriding or neglecting its wishes in tragic circumstances, and efforts to avoid professional vultures taking organs over the protests of grieving families. In the U.S. the transfer of solid organs occurs by express donation of the individual or family with ethical ...