Loewy E H
Bioethics, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
Theor Med. 1996 Mar;17(1):61-74. doi: 10.1007/BF00489741.
This paper makes the assumption that organ transplantation is, under some conditions at least, a proper use of communal medical resources. Proceeding from this assumption, the author: (1) sketches the history of the problem; (2) briefly examines the prevalent models of communal structure and offers an alternate version; (3) discusses notions of justice and obligation derived from these different models; (4) applies these to the practice of harvesting organs for transplantation; and then (5) offers a different process for harvesting organs from the newly dead. If community is viewed as united by a set of shred goals and common values among which the value of community itself is important, then certain reciprocal obligations among members obtain. I suggest that routine salvage of organs from the newly dead be instituted but that it be routine salvage "with a twist": rather early in life all members of the community are given the opportunity to refuse but their refusal carries the reciprocal condition that they cannot later become the recipients of that which they refuse to others.
本文假定，至少在某些情况下，器官移植是对公共医疗资源的合理利用。基于这一假设，作者：（1）概述了该问题的历史；（2）简要审视了流行的社会结构模式并提出了另一种模式；（3）讨论了源自这些不同模式的正义和义务观念；（4）将这些观念应用于器官移植的获取实践；然后（5）提出了一种从刚去世者身上获取器官的不同流程。如果将社会视为由一系列共同目标和共同价值观联结而成，其中社会自身的价值很重要，那么成员之间就会产生某些相互义务。我建议实行从刚去世者身上常规获取器官的做法，但这种常规获取要有“变通”：在人们早年时，社会所有成员都有机会拒绝，但他们的拒绝带有相互条件，即他们日后不能成为接受他人所拒绝之物的接受者。
