Kidney allocation for transplantation: some aspects of ethics and comparative law

The allocation of organs is a crucial ethical issue. The importance attached to different allocation criteria differs considerably among the various national and international organizations. The balance between justice-centered and utility-centered systems is shifting and there are signs of a possible swing away from systems centered mainly on waiting times to others centered mainly on criteria of utility. This evolution is very significant and seems to run counter to the main stream of modern bioethics. Examples from different national policies are given herein. Particular attention is given to Europe, where national bioethics committees have tended to ignore the aspect of organ allocation. By overemphasizing the issues related to informed consent, the ethical challenges arising from the problems of resource allocation are often relegated to second place.