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A unified approach to organ donor recruitment, organ procurement, and distribution.

The practices of organ procurement and organ donor recruitment in the United States rest upon two significant but incorrect assumptions. The first is that validly signed donor cards have merely advisorial function; that is, that their purpose is simply to communicate the supposedly nonbinding desires of deceased or incompetent potential donors to serve as sources of lifesaving organs and tissues after death. Procurement personnel do not accord these documents the legal force of wills. Hence, they invariably ask families of all potential donors declared and undeclared for permission to remove organs and tissues from deceased kin. This practice is, however, (a) inconsistent with both the spirit and the letter of nearly all state Uniform Anatomical Gift Acts; (b) inconsistent with the defensible claim that the majority of interests bound up with ownership apply to the relation of a person to his or her body during life and after death; and (c) almost unanimously judged to be morally unacceptable by respondents in two recent empirical surveys..The paper proposes an appropriate revised procedure for use by procurement staff in counseling with families of deceased declared donors. A second incorrect assumption lies at the heart of donor recruitment campaigns. This is the assumption that consenting to the posthumous removal of organs from one's own body is an act of charity, a work of superergogation. The author argues to the contrary that consenting to the removal and transfer of one's own organs after death is a moral duty. The duty to consent is derivative from a more general moral duty variously called the duty of mutual aid or the duty to attempt an easy rescue of an endangered person (or persons). So, while it is true that every individual has first authority, i.e., paramount right over all others, to control the posthumous disposition of his or her own body parts after death, the author argues that this right is overridden by the more weighty moral duty to consent to the removal and transfer of personal organs after death. * Chairman, Department of Philosophy, University of Wisconsin, River Falls,