Organ Transplant Policies and Cultural Worldviews

Live organs allocation policies have been subject in many countries to central government regulatory frameworks and oversight. Government regulations, organizational principles, and occupational standards are all aligned to the moral value of caring first and foremost for patients and ensuring that the allocation of organs complies with the notions of sound medical judgment, and responsible administration. The chapter offers an overview of the main trends and values associated with organ transplant policies. It also focuses on major departure from the moral principles and the subversion of medical ethical rules. The purpose is to understand what factors undermine the capacity of doctors to act as amoral actors, and under what conditions they choose organizational compliance at the expense of professional ethics. In 2012–2013 the German transplant system suffered from a large public scandal over the manipulation of patients’ data to move them up on the waiting list. Similar manipulations are reported to have occurred in the U.S., though on a different scale. The chapter shows the highly problematic nature of gaming when it escalates at all levels of a governance system and when it involves unethical decisions, defined as subversion of ethical medical standards.