Distributive Justice: Should Todd Krampitz

Distributive Justice: Should Todd Krampitz Have Received a Liver Transplant Ahead of Others? In today's world, increasingly, one of the most difficult dilemmas, for individuals, groups, and societies alike, relates to issues of distributive justice, for instance, fair and equitable allocation of valuable but scarce resources, such as donated organs for human transplantation purposes. Unfortunately, many more Americans (and others throughout the world) need donated organs (e.g., livers, hearts, kidneys) in order to receive organ transplants that could save their lives. However, chronic organ and organ donator shortages exist.

However, last year one young man needing of a liver transplant, Todd Krampitz of Houston, Texas, along with his family, took matters into their own hands, putting up billboards and creating a website at their own time and expense, in order to advertise Todd's need for a liver.

According to the web article "Man gets liver after using billboards, Net" (August 13, 2004): His family decided to mount a media campaign, including two billboards along one of Houston's busiest freeways, and a Web site that detailed his plight and raised awareness about organ donation. Krampitz and his wife Julie also did national media interviews after word of his efforts spread.

(MSN.com) The quest for a donated liver for Todd was successful: from the web billboard advertising (which, obviously, not everyone needing a liver, or his or her family, can afford) a donor emerged, and Todd received a liver ahead of others on the national list to receive livers for transplants. Todd was able to have his operation, but even then it was too late; he died anyway from his disease.

Still, the efforts of Todd and his family were valiant, impressive, and (at least in my opinion) entirely justified, even if it did put Todd ahead of others in need of liver transplants.

Ethically and morally, though, the question still arises as to rather it was justified, whatever Todd's needs, and whatever his particular family's financial and creative means, for Todd to receive a liver in this way, donated for him alone (instead of, hypothetically, being forced to give up this liver, even though for him alone, to someone ahead of him on the national liver transplant list.

To believe that Todd's earlier-than-otherwise receipt of a liver was unfair would also be to believe that organs like livers, hearts, and kidneys are otherwise always fairly distributed, based on a combination of patient waiting and perceived medical need. That, however, is not the case.

Several years ago, for example, the news media reported that baseball superstar Mickey Mantle needed a liver transplant, and it seemed that almost before the ink was dry on those newspaper reports, Mantle was in the hospital having his liver transplant, while others (e.g., less famous or well-connected individuals like Todd Krampitz and others) still waited their turn behind Mickey Mantle.

While no one ought to begrudge Mickey Mantle (or anyone) a much-needed liver transplant, it remains hard to believe, given the speed at which Mickey Mantle received a liver and an operation that he was indeed placed on a list and then waited his turn like everyone else. Further, according to Koch (March 1996)Normative and prescriptive criteria: The efficacy of organ transplantation allocation protocols (March 1996): well publicized cases have raised questions in North America about the efficacy of [donated organ] allocation procedures.

An analysis of those cases, and the relevant technical literature, suggest consistent structural deficits exist in the organ allocation process as it is applied by many individual transplantation centres. These irregularities are based upon both the failure of rank waiting as a method to guarantee just treatment and a general failure to recognize the extent to which prescriptive criteria -- social values -- are commonly used to screen potential organ transplant candidates.

Resulting idiosyncratic determinations, and a devaluation of rank waiting as a criterion, raise fundamental questions regarding justice, fairness, and equability in the application procedure at large. In an ideal world (which ours, unfortunately, is very far from being), it might well seem unethical, immoral, and unjust for Todd Krampitz to have "cut ahead of others" on a waiting list for liver transplants. That same argument, however, could be made about Mickey Mantle's speedy receipt of a liver transplant while others still waited their turn.

On the other hand, as Koch (March 1996) points out many may be reticent to even become organ donors if.