Beginning in 1993, the Ethics Committee (the Committee) developed a series of white papers that are available through the Organ Procurement and Transplantation Network (OPTN) website. A white paper is an authoritative report or guide that informs readers concisely about a complex issue and presents the issuing body's philosophy on the matter. It is meant to help readers understand an issue, solve a problem, or make a decision.
There have been recent reports describing the manipulation of waitlist priority of the organ allocation system in both the medical literature and the lay press. To date, the OPTN and the United Network for Organ Sharing (UNOS) have not offered guidance or established a formal position statement on this issue.
This white paper will define and present an ethical analysis of manipulation of the waitlist priority of the organ allocation system through the use of medically unnecessary interventions that are used to increase a transplant candidate’s priority on the waitlist. The white paper will delineate the potential harms to transplant candidates, the wait list as a whole, transplant providers, and transplant hospitals involved in the manipulation of the organ allocation system.