AST Statement on Ethics in Organ Transplantation

This ethics statement was developed and approved for the following purposes:

1. AST will apply these principles in all educational, scientific, and policy endeavors
2. AST will not ask its members to participate in any activity that violates these principles.
3. Designated AST representatives will adhere to these principles when operating in an official capacity.
4. AST supports pursuit of these principles by its members.

Uniquely in modern medicine, solid organ donation and transplantation requires interaction among multiple parties, well beyond the usual patient-provider relationship. For instance, availability of organs influences decision-making in patient care for all involved. These complex dynamics require maintenance of the highest moral and ethical standards. The following principles should inform the practice of all participating professionals.

I. AUTONOMY

• All participants in solid organ transplantation (donors, recipients, providers, investigators) should be respected as autonomous individuals whose interests may not always coincide.
• Healthcare providers, recipients (or candidates) and living donors bring personal, philosophical, and religious beliefs that should be respected.
• All participants must be fully informed of the risks and benefits of all procedures.
• Privacy and confidentiality are the norm for both donors and recipients.

II. EQUITY

• Medical criteria must be the primary determining factors in transplant decision-making.
• Fair allocation of scarce organs must be free from discrimination and include consideration of the likelihood of successful transplantation.
• Similar candidates should have similar access to transplantation.

III. QUALITY

• Recipients and living donors should expect to receive quality care, targeted to the individual and meeting accepted standards, at all transplant centers.
• Quality care may require referral to another center for services needed but not offered at any single center.
• Support of innovation and research are essential to transplantation but should be offered only after careful consideration of potential risks and benefits with appropriate informed consent.

IV. ORGAN DONATION

• The care of potential deceased donors must not be compromised with a view to the possible transplant. Standard procedures concerning determination of death or the withdrawal of treatment must be followed by the potential donor's own physicians.
• Among living donors, the decision to donate must be freely made, without coercion or exploitation.
• Neither living donors nor families of deceased donors should profit financially or be financially disadvantaged from donation.

Approved by the AST BOD: January 15, 1999
Revised: February 2001
Revised: October 2002
Revised and Approved by the AST Board of Directors on December 6, 2012.