The Ethics of Bypassing UNOS Allocation Rules to Save a Patient

Every ten minutes, someone is added to the organ transplantation waiting list, but not everyone has an equal chance of receiving a life-saving organ. This presentation explores whether a surgeon should break the rules of the United Network for Organ Sharing (UNOS) to save a patient who has been unfairly placed lower on the list due to systemic biases. This presentation shows that the organ allocation system that should be fair has very evident flaws. In cases like Mickey Mantle, where celebrities have received transplants quickly, concerns about favoritism were raised. Additionally, the use of race-based calculations that overestimated kidney function in black patients, delayed their access to transplants proving that disparities are present. Changes were made but issues are still present. Some argue that a surgeon should follow the rules while I believe saving a life comes before policy. This dilemma is analyzed through the lens of three ethical theories. Cultural relativism argues that since society has agreed upon these rules, they should be followed. Utilitarianism argues that breaking the rules is justified if it leads to the greatest overall happiness. Care ethics emphasize the personal duty to help someone in need and prioritize compassion over rigid rules. Additionally, the American Board of Surgery’s (ABS) ethical code emphasizes fairness and patient care; supporting that a surgeon should go against unjust policies. Ultimately, this presentation concludes that a surgeon is justified in breaking UNOS rules when they see injustice. It is not ethical to blindly follow a flawed system.