Is the adoption of more efficient strategies of organ procurement the answer to persistent organ shortage in transplantation?

[I]s persistent organ shortage the major obstacle to the performance of more procedures as often popularly portrayed? Does the answer therefore lie in the adoption of more efficient strategies of organ procurement? While the measures taken to improve the efficiency of organ procurement may be inspired by the laudable motive of saving lives, they may ultimately prove to be myopic if the larger ethical issues raised by organ transplant programs for the allocation of national and organ resources are not given their due consideration. For any society that desires to include organ transplantation in its health delivery system, it must consider the social and ethical issues that transplant programs raise for the macroallocation of available national resources and the manner by which organ resources are procured, and distributed. The failure to resolve these issues in an ethically acceptable manner at any of these levels would render any transplant program ethically indefensible. This essay therefore argues that before a society decides on its policy of organ procurement it ought to make prior assessments of: a) its social priorities; b) the policies for ensuring fair access to organ resources; and c) the extent to which it is willing to support transplants.