ABSTRACT
This chapter presents and defends the view that a system of mandated choice involving two steps to three choices constitutes the ethically and pragmatically preferred route for retrieving cadaveric organs for transplantation. It holds this option to the litmus of bioethical principles and pragmatism, notes the proposed system's strengths and weaknesses, and calls for pilot programs. The first step of this approach would involve a broad based, ongoing educational campaign systematically informing the general public about issues surrounding organ shortage. The approach suggested here differs from the Texas model significantly. A carefully designed strategy to pilot a mandated choice system remains untested. Bioethicists have studied American values and extracted a number of relevant gold standards including autonomy, beneficence, and justice. This chapter addresses the ethical underpinnings only of the second step: three-prong mandated choice. It discusses a two-prong mandated choice paradigm in the literature.
