Organ Transplants, Foreign Nationals, and the Free Rider Problem

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Theoretical Medicine


free rider argument, foreign nationals, organ allocation


There is strong sentiment for a policy which would exclude foreigners from access to organs from American cadaver donors. One common argument is that foreigners are 'free riders'; since they are not members of the community which gives organs, it would be unfair to allow them to receive such a scarce resource. This essay examines the philosophical basis for the free rider argument, and compares that with the empirical data about organ donation in the U.S. The free rider argument ought not to be used to exclude foreign nations because it is based on fallacious assumptions about group membership, and how the 'giving community' is defined. Polls show that even among the seventy-five per cent of Americans who support organ donation, only seventeen per cent had taken the small step of filling out donor cards. Therefore, it goes against logic to define the giving community as coextensive with American residency, while excluding foreigners who might well have become donors had they lived in countries which provided that option.



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