The first of two articles in this file, “Organs for Change,” provides a concise history of organ transplantation, clinical medical ethics, and their intersections. Of transplantation’s ethical issues, Dr. Siegler says, “if you can grasp the ethical issues in transplantation, you grasp the major ethical issues in medicine.” Clinical medical ethics emerged as a field in the 1970s, challenged by the two major principles of organ donation: how to fairly increase supply and methods for equitable distribution. Dr. Siegler and his colleagues developed methods for ethical oversight with surgical innovation and establishing paired kidney exchange (including a Congressional amendment to the 1984 ban on organ sales). Fairly increasing organ supply continues to be a challenge as waiting lists are growing without a commiserate number of donors. Dr. Siegler’s solution includes further amendment of the 1984 ban to allow for a regulated system of organ sales.
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