The ethics of organ transplantation: how comprehensive the ethical framework should be?

Organ transplantation is one of the major medical achievements of the twentieth century (Mancuso 2006:138). The discovery of effective immunosuppressive drugs in the late 1970s was an important step towards increasing the success rate of organ transplants and thus paved the way for organ transplantation to become a medical routine affair in the twenty-first century (Schmidt 2003: 319). The current prevalence of organ transplantation was clearly to see in a recently published study which assembled worldwide data on living kidney transplantation. The study showed steady rise of living kidney transplantation in most regions of the world. According to statistics given by this study, ‘‘The number of living kidney donor transplants grew over the last decade, with 62% of countries reporting at least a 50% increase. The greatest numbers of living donor kidney transplants, on a yearly basis, were performed in the United States (6435), Brazil (1768), Iran (1615), Mexico (1459), and Japan (939). Saudi Arabia had the highest reported living kidney donor transplant rate at 32 procedures per million population (pmp), followed by Jordan (29), Iceland (26), Iran (23), and the United States (21)’’ (Horvat et al. 2009:1088). When a medical treatment, like organ transplantation, becomes so prevalent and manages to achieve impressive success rates in improving the quality of patients’ lives worldwide then intriguing ethical questions will be raised by default. The main thesis of this thematic issue is that the ethical framework of organ transplantation should be as comprehensive as possible and thus should not be confined to conventional set of ethical questions related to the donor–recipient relationship. The first article in this thematic issue argues that media ethics should be incorporated in this ethical framework. The second article asks for more critical consideration to the requirement of consent, which underlines the authority of people in regard to their bodies. The third article speaks of a need to offer pyschological care to the living kidney transplantation partners before and after transplantation. The fourth and fifth articles elaborate on the need to involve the religious aspects in the ethical discourse on organ donation.