An Ethical Analysis of Split Liver Transplantation.

Abstract

A.This paper will present the findings from an in-depth analysis of the ethical issues surrounding split liver transplantation, to establish whether, and if so, how, the existing practice of splitting livers from deceased donors can be justified. B.The method is primarily philosophical analysis/argument, but this will draw upon up-to-date published data about outcomes of split liver transplantation and waiting times/waiting list mortality. C.We will argue the following: i) That some common characterisations of liver splitting (e.g. that splitting places the interests of children above those of adults, that splitting livers harms adults to benefit children, and that splitting is detrimental to a donated liver) are inaccurate. ii) That splitting livers can be justified on the grounds of justice and utility, rather than anything special about children; iii) Splitting livers (and offering more, yet riskier transplants generally) may affect who dies and how they die, but we argue that an assumed morally significant difference between dying without a transplant and dying after a transplant may be incorrect. D. We will conclude that the splitting of livers can be ethically justified, and that it may be justifiable to split more livers. We also conclude that the justification we endorse could also justify changes to splitting/allocation policy if further progress is made relating to splitting livers, to distribute additional benefit to adults as well as/instead of children.