title: Liver, pancreas and small bowel transplantation: current ethical issues.
abstract: We describe the medical state of the art in liver, pancreas and small bowel transplantation, and portray the ethical issues. Although most ethical questions related to these transplantations are not specific for liver, pancreas and small bowel, they do challenge ethical analysis as well as new policies and clinical procedures. Firstly, outcomes continue to be of utmost concern, as information is only limited available, is developing over time and is surrounded by many uncertainties. Secondly, characteristics of donors and recipients should be carefully evaluated. The question of what qualifies a donor and a recipient should be considered against the background of a quest for extended criteria, embracing marginal cases, and a judgment with regard to what counts as a good enough outcome. Thirdly, ethical principles of autonomy and fairness are pushed, given the circumstance of severe scarcity, towards limits that can easily be crossed.
authors.affiliation: Department of Medical Ethics and Philosophy of Health Care, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: g.vandijk.2@erasmusmc.nl.
authors.forename: Gert
authors.initials: G
authors.lastname: van Dijk
authors.affiliation: Department of Medical Ethics and Philosophy of Health Care, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: m.hilhorst@erasmusmc.nl.
authors.forename: Medard
authors.initials: M
authors.lastname: Hilhorst
authors.affiliation: Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands; Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands; Address: P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: e.rings@erasmusmc.nl.
authors.forename: Edmond
authors.initials: E
authors.lastname: Rings
mesh_terms: D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent; D007421:Intestine, Small / Q000637:transplantation*; D016031:Liver Transplantation; D016035:Pancreas Transplantation; D018570:Risk Assessment / Q000941:ethics; D014019:Tissue Donors / Q000941:ethics; D014180:Transplantation / Q000941:ethics
keywords: Benefits; Consent; Donation; Fairness; Kidney transplantation; Liver transplantation; Pancreas transplantation; Risks; Small bowel transplantation