This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as “reuse cardiac organ transplantation.” Medical, legal, and ethical analysis, with a main focus on ethical analysis. From the medical perspective, it is (...) critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver. (shrink)

In this book G. A. Cohen examines the libertarian principle of self-ownership, which says that each person belongs to himself and therefore owes no service or product to anyone else. This principle is used to defend capitalist inequality, which is said to reflect each person's freedom to do as as he wishes with himself. The author argues that self-ownership cannot deliver the freedom it promises to secure, thereby undermining the idea that lovers of freedom should embrace capitalism and the inequality (...) that comes with it. He goes on to show that the standard Marxist condemnation of exploitation implies an endorsement of self-ownership, since, in the Marxist conception, the employer steals from the worker what should belong to her, because she produced it. Thereby a deeply inegalitarian notion has penetrated what is in aspiration an egalitarian theory. Purging that notion from socialist thought, he argues, enables construction of a more consistent egalitarianism. (shrink)

Left-libertarianism is a version of Lockean libertarianism that combines the idea that each person is the full rightful owner of herself and the idea that each person should have the right to own a roughly equal amount of the world's resources. This essay argues against left-libertarianism. The specific target is an interesting form of left-libertarianism proposed by Michael Otsuka that is especially stringent in its equal world ownership claim. One criticism advanced is that there is more tension than Otsuka acknowledges (...) between private ownership of self and equal ownership of the world. This emerges once one notices that self-ownership should not be conceived merely in a thin, formal way but also as a thicker substantive insistence on wide individual freedom. A second criticism is that in other respects the formal idea of self-ownership that Otsuka and other left-libertarians embrace is an extreme doctrine that merits rejection. (shrink)

The principle that each person is his own property occupies an almost axiomatic status in right-wing liberal thought as well as in some egalitarian theories. I reject any, full or partial, notion of property with respect to oneself by showing that any appeal and any justifiability which may be associated with self-ownership can at most serve to ground rights which are demonstrably non-property rights. As a contrast to self ownership, I introduce the non-proprietarian notion of Original Freedom. I compare the (...) two with respect to the control, income, and transfer aspects of ownership and suggest that Original Freedom is the more intuitively acceptable. (shrink)

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