Self-Sufficiency or Autarkeia? Introducing an Aristotelian Perspective on Organ Transplantation Ethics

Abstract

Introduction: This paper explores parallels between Aristotle's ethics and emerging themes in organ transplantation policy, in particular the pursuit of national self-sufficiency. No longer confined by an individualized conception of altruism and organ donation as a supererogatory act, the ethos of transplantation is evolving as communities and governments recognize the nature of donation and transplantation as a necessarily public concern. Methods: Recent literature concerned with organ donation and allocation ethics is reviewed in conjunction with Aristotle's accounts of economy, self-sufficiency and civic virtue in The Politics. Aristotle's theories are explored in the context of contemporary ethical issues in organ transplantation in order to identify common themes, challenges and suggestions for future ethics research and policy making. Results: Solidarity, reciprocity, justice and even civic duty have become potential rationales for donation policies, in particular those which encourage nations or regions to strive to meet their own needs for transplantation without reliance on foreign outsourcing, thus achieving self-sufficiency. These values reflect key themes in Aristotle's Politics and suggest that an Aristotelian perspective of current debates in transplantation ethics offers a valuable source for future examination, in particular with respect to emerging conceptions of national self-sufficiency in organ donation and transplantation. Conclusion: Aristotelian ethics have long been neglected as a source of guidance in transplantation ethics. Future work in this area will benefit greatly from an examination of the ancient past.