WP3 Blog 2: Position on the Ethical Dilemma of Organ Allocation System

Despite the imperfection of the OPTN organ allocation system, I believe the federal court should not have the authority to overrule an OPTN decision due to the difference in nature and purpose of the two systems. All transplantation candidates' lives are dependent on the system. Since decisions from the federal court closely correlate with the changes in the organ allocation system, any changes in the OPTN system must be carefully reviewed with solid medical evidence from the board of directors before being implemented to ensure justice and beneficence within the organ allocation system. Any ruling from the court without confirmation from the medical professional could be setting several patients' life at unjustified risk, which is irresponsible.

The nature of the court, with lawyers and judges, is a game of persuasion. Opinions, affected by media, pathos, and perspectives, play a significant role in the final decisions. Such conflicts with the purpose of the OPTN organ allocation system, which strives to avoid organ allocation becoming a competition. The judgments from the OPTN board of directors, composed of experienced medical professionals in varying fields and bioethicists, should be nonnegligible.

Even if the OPTN system is flawed, as Sarah Murnaghan's case exemplified in the deviance in donor pool size, there must be an alternative way of fixing the system without breaking the rules. Breaking the rules to foster changes discredits the system, which negatively impacts the system's operation in the long term. One may suggest the low efficiency of the board as an unjust permanent flaw of the system, as eligible candidates could die during the review. However, one should also acknowledge that it's crucial for the board to take time to fully evaluate the effects of the change, especially when it's a life-or-death decision for patients both in the present and in the future. Efficiency could be a factor that the board should strive to improve, but jumping over the process for any case is irresponsible for other eligible candidates of the distinct transplants. The urge for a transplant is understandable, but the approach is unethical. Thus, the court shouldn’t have the right to overrule an OPTN decision.


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