Altruism, motivation, and allocation: giving and using human organs.

With tens of thousands of waiting recipients but only 4000-5000 organs available annually, there is a chronic and largely insatiable demand for organ transplants. This article draws on three sources of data regarding the sources of organs donated: a survey of the families of organ donors, a survey of the general public, and a prospective data collection effort from organ procurement agencies. It considers which Americans are willing to engage in this kind of altruism. Furthermore, it discusses the obligations imposed on the nation's public organ procurement and allocation system by the fact that organs are obtained as gifts. It argues that, as all Americans may be asked to donate and there would be social costs to excluding some from a moral community to givers and recipients, all Americans ought to have equal access to organ transplantation.