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Jul 09, 2018

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  • Organ Shortage: Ethics, Law and Pragmatism

    Organ shortage is an ongoing problem in many countries. The needlessdeath and suffering which have resulted necessitate an investigation intopotential solutions. This examination of contemporary ethical means,both practical and policy-oriented, of reducing the shortfall in organsdraws on the experiences of a range of countries. The authors focus onthe resolution and negotiation of ethical conflict, examine systemsapproaches such as the Spanish Model and the US BreakthroughCollaboratives, evaluate policy proposals relating to incentives, pre-sumed consent and modifications regarding end-of-life care, andexamine the greatly increased use of (non-heart-beating) donors suffer-ing circulatory death, as well as living donors. The proposed strategiesand solutions are capable not only of resolving the UKs own organ-shortage crisis, but of being implemented in other countries grapplingwith how to address the growing gap between supply and demand fororgans.

    Dr Anne-Maree Farrell is Senior Lecturer in Law at the Centre for SocialEthics and Policy and the Institute for Science Ethics and Innovation,School of Law, University of Manchester.

    Professor David Price is Professor of Medical Law at Leicester DeMontfort Law School, De Montfort University.

    Dr Muireann Quigley is Lecturer in Bioethics at the Centre for SocialEthics and Policy and the Institute for Science Ethics and Innovation,School of Law, University of Manchester.

    www.cambridge.org in this web service Cambridge University Press

    Cambridge University Press978-0-521-19899-8 - Organ Shortage: Ethics, Law and PragmatismAnne-Maree Farrell, David Price and Muireann QuigleyFrontmatterMore information

    http://www.cambridge.org/9780521198998http://www.cambridge.orghttp://www.cambridge.org

  • Cambridge Law, Medicine and Ethics

    This series of books was founded by Cambridge University Press with AlexanderMcCall Smith as its first editor in 2003. It focuses on the laws complex andtroubled relationship with medicine across both the developed and the developingworld. In the past twenty years, we have seen inmany countries increasing resort tothe courts by dissatisfied patients and a growing use of the courts to attempt toresolve intractable ethical dilemmas. At the same time, legislatures across theworld have struggled to address the questions posed by both the successes andthe failures of modern medicine, while international organisations such as theWHO and UNESCO now regularly address issues of medical law.

    It follows that we would expect ethical and policy questions to be integral tothe analysis of the legal issues discussed in this series. The series responds to thehigh profile of medical law in universities, in legal and medical practice, as wellas in public and political affairs. We seek to reflect the evidence that many majorhealth-related policy debates in the UK, Europe and the international commun-ity over the past two decades have involved a strong medical law dimension.Organ retention, embryonic stem cell research, physician assisted suicide andthe allocation of resources to fund healthcare are but a few examples amongmany. The emphasis of this series is thus on matters of public concern and/orpractical significance. We look for books that could make a difference to thedevelopment of medical law and enhance the role of medico-legal debate inpolicy circles. That is not to say that we lack interest in the important theoreticaldimensions of the subject, but we aim to ensure that theoretical debate isgrounded in the realities of how the law does and should interact with medicineand healthcare.

    General EditorsProfessor Margaret Brazier, University of Manchester,Professor Graeme Laurie, University of Edinburgh

    Editorial Advisory BoardProfessor Richard Ashcroft, Queen Mary, University of London,Professor Martin Bobrow, University of Cambridge,Dr Alexander Morgan Capron, Director, Ethics and Health, World

    Health Organization, Geneva,Professor Jim Childress, University of Virginia,Professor Ruth Chadwick, Cardiff Law School,Dame Ruth Deech, University of Oxford,Professor John Keown, Georgetown University, Washington, DC,Dr Kathy Liddell, University of Cambridge,Professor Alexander McCall Smith, University of Edinburgh,Professor Dr Mnica Navarro-Michel, University of BarcelonaMarcus Radetzki, Marian Radetzki and Niklas Juth Genes and Insurance:Ethical, Legal and Economic Issues

    www.cambridge.org in this web service Cambridge University Press

    Cambridge University Press978-0-521-19899-8 - Organ Shortage: Ethics, Law and PragmatismAnne-Maree Farrell, David Price and Muireann QuigleyFrontmatterMore information

    http://www.cambridge.org/9780521198998http://www.cambridge.orghttp://www.cambridge.org

  • Ruth Macklin Double Standards in Medical Research in DevelopingCountries

    Donna Dickenson Property in the Body: Feminist PerspectivesMatti Hyry, Ruth Chadwick, Vilhjlmur rnason,Gardar rnason TheEthics and Governance of HumanGenetic Databases: European Perspectives

    KenMason The Troubled Pregnancy: Legal Wrongs and Rights inReproduction

    Daniel Sperling Posthumous Interests: Legal and Ethical PerspectivesKeith Syrett Law, Legitimacy and the Rationing of Health CareAlastair Maclean Autonomy, Informed Consent and the Law: A RelationalChange

    Heather Widdows and Caroline Mullen The Governance of GeneticInformation: Who Decides?

    David Price Human Tissue in Transplantation and ResearchMatti Hyry Rationality and the Genetic Challenge: Making People Better?Mary Donnelly Healthcare Decision-Making and the Law: Autonomy,Capacity and the Limits of Liberalism

    Anne-Maree Farrell, David Price andMuireann Quigley Organ Shortage:Ethics, Law and Pragmatism

    www.cambridge.org in this web service Cambridge University Press

    Cambridge University Press978-0-521-19899-8 - Organ Shortage: Ethics, Law and PragmatismAnne-Maree Farrell, David Price and Muireann QuigleyFrontmatterMore information

    http://www.cambridge.org/9780521198998http://www.cambridge.orghttp://www.cambridge.org

  • Organ ShortageEthics, Law and Pragmatism

    Anne-Maree Farrell,

    David Price

    and

    Muireann Quigley

    www.cambridge.org in this web service Cambridge University Press

    Cambridge University Press978-0-521-19899-8 - Organ Shortage: Ethics, Law and PragmatismAnne-Maree Farrell, David Price and Muireann QuigleyFrontmatterMore information

    http://www.cambridge.org/9780521198998http://www.cambridge.orghttp://www.cambridge.org

  • cambridge univers ity pressCambridge, New York, Melbourne, Madrid, Cape Town,Singapore, So Paulo, Delhi, Tokyo, Mexico City

    Cambridge University PressThe Edinburgh Building, Cambridge CB2 8RU, UK

    Published in the United States of America by Cambridge University Press,New York

    www.cambridge.orgInformation on this title: www.cambridge.org/9780521198998

    Cambridge University Press 2011

    This publication is in copyright. Subject to statutory exceptionand to the provisions of relevant collective licensing agreements,no reproduction of any part may take place without the writtenpermission of Cambridge University Press.

    First published 2011

    Printed in the United Kingdom at the University Press, Cambridge

    A catalogue record for this publication is available from the British Library

    Library of Congress Cataloguing in Publication dataOrgan shortage : ethics, law, and pragmatism / [edited by] Anne-Maree Farrell,David Price, and Muireann Quigley.p. cm. (Cambridge law, medicine, and ethics) Includes bibliographical

    references and index.ISBN 978-0-521-19899-81. Organ donors Supply and demand. I. Farrell, Anne-Maree, 1964II. Price, David P. T. III. Quigley, Muireann. IV. Title. V. Series.RD129.5.O748 2011362.190795dc22

    2010030513ISBN 978-0-521-19899-8 Hardback

    Cambridge University Press has no responsibility for the persistence oraccuracy of URLs for external or third-party internet websites referred toin this publication, and does not guarantee that any content on suchwebsites is, or will remain, accurate or appropriate.

    www.cambridge.org in this web service Cambridge University Press

    Cambridge University Press978-0-521-19899-8 - Organ Shortage: Ethics, Law and PragmatismAnne-Maree Farrell, David Price and Muireann QuigleyFrontmatterMore information

    http://www.cambridge.org/9780521198998http://www.cambridge.orghttp://www.cambridge.org

  • Contents

    List of figures page ixList of tables xContributors xiAcknowledgements xviiiList of abbreviations xixTable of cases xxiTable of legislation xxii

    Part I Setting the scene 1

    1 A principled and pragmatic approach to organ shortage 3anne-maree farrell, david price and muireann

    quigley

    2 Does ethical controversy cost lives? 15margaret brazier and john harris

    Part II Current issues affecting organ shortage 35

    3 Organ donation and transplantation: meeting the needs of amulti-ethnic and multi-faith UK population 37gurch randhawa

    4 Educating the public to encourage organ donation? 52mairi levitt

    5 Bereavement, decision-making and the family in organdonation 67magi sque and tracy long-sutehall

    Part III Strategies for addressing organ shortage 87

    6 Incentivising organ donation 89muireann quigley

    vii

    www.cambridge.org in this web service Cambridge University Press

    Cambridge University Press978-0-521-19899-8 - Organ Shortage: Ethics, Law and PragmatismAnne-Maree Farrell, David Price and Muireann QuigleyFrontmatterMore information

    http://www.cambridge.org/9780521198998http://www.cambridge.orghttp://www.cambridge.org

  • 7 Making themargins mainstream: strategies to maximise thedonor pool 104antonia cronin

    8 The allocation of o