Distributive Justice – Transplantation&Donation Example

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"Distributive Justice" is a perfect example of a paper on transplantation and donation. Mr. Todd Krampitz, a 32-year old man from Houston, Texas was battling liver cancer. He had a huge tumor and his liver was beginning to fail. A rare and courageous decision was made by a family that had lost a loved one, by donating a liver and Krampitz underwent surgery receiving the organ. It is arguable that the system worked in saving a life; however, in this scenario, the system failed. The fact that a life was saved by Krampitz receiving the organ remained unethical because he got it by cutting in line.                           Every year there is a long list of people in the US waiting for organ transplants.

The list is managed by a public agency the United Network for Organ Sharing, that operating under the Department of Human Services. The agency was created to ensure that everyone in need of an organ transplant received a fair and equitable chance. The purpose of this paper is to discuss the ethical issue surrounding Mr. Krampitz's case of organ acquisition.     Getting around the system                       Looking from the perspective of equality as applicable to justice, and all other things kept constant, a question arises on who has a say on transplant organs in the US,   I presume an obvious answer would be anyone in need of them.

But since the number of patients requiring the organs outweighs available organs, the presupposed assumption will not work. Therefore, the method used to ensure equity remains to be on the first come first serve, and youngest to old priority (Moon, 2008). In the case of Krampitz, the length of waiting time was disregarded.

There must have been thousands of other patients on the waiting list and while Krampitz might have been reasonably young being 32 years of age, he was most likely not the youngest of them all on the waiting list. Using means best known to him, Mr. Krampitz managed to surpass the equity and fairness test, a thing the other patients on the waiting list could not achieve.                             The other issue was the need; everyone on the waiting list I suppose believed that their needs were greatest.

During life and death situation, a person would not shun a chance for survival, and trying to convince a patient to forfeit a chance and wait for the next one may not be fruitful (Doig & Rocker, 2003). A patient would fight to the death using all means available to ensure that they get the first chance. This is the reason why patients are kept in dark on the availability of organs until a decision on who gets the organ is reached.                       During the time of the Krampitz transplant, thousands of people were on the waiting list also in need of the same organ with some being more desperate than Krampitz.

Some of these patients came from Krampitz home town of Texas. Both Krampitz and his doctor were aware of the organ distribution system; however, decide to go around the system by posting ads on billboards around Houston, placing ads on newspapers, and appearing on television shows, which served their purpose. Their main objective was not to encourage more organ donations but a direct donation to Krampitz and they attained their objective.                       Krampitz’ s successful acquisition of liver transplant through none procedural means was wrong, though he had the right to try every means to save his life, the point of having an organ distribution system was to give everyone a fair and equitable chance of acquiring one and not just individuals with the capabilities to pay expensive ads and make an appearance on national television.

Therefore Krampitz’ s actions were a direct violation of distributive justice and ethics.                       The system considered to have been effective for almost twenty years used complex sets of steps including tissue type, blood type, donor size, the likelihood of survival, and urgency in the organ distribution.

Krampitz no doubt would still have gotten a liver using the system (Spicer, 2008). He was not considered to be as near-death compared to other patients on the day of surgery and his liver cancer was not so advanced that it might not have been possible to make a transplant on any other future date. In fact, one Texas surgeon was quoted to have said that; that day was liver transplantation's saddest day when a person at the bottom of the waiting list hijacked a chance.                           No one has the right to deny anyone a chance to save their lives, but in the case of organ transplant, available organs should save lives in an equitable and fair manner.

A system in place ensures that these organs are issued so that everyone has a fair chance. Krampitz circumvents the system and it is possible that someone who might have been in need of liver more than Krampitz died because Krampitz could not wait.

Krampitz was guilty of distributive justice and violation of ethics. To prevent such cases from occurring in the future, the system needs to be revised to curb loopholes such as the one used by  Krampitz.            


Doig, C. & Rocker, G. (2003). Retrieving organs from non-heart-beating organ donors: a

review of medical and ethical issues. Canadian Journal of Anesthesia, 50(10), 1069-1076.


Moon, L. (2002). Organ Allocation. Retrieved on March 5, 2012, from http://


Spicer, J. (2008, Nov. 21). Distributive justice. Practice Nurse, 36(9), 45-48.

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