Jeffrey Pannekoek

Uterine transplantation (UTx) is an innovative and exciting development that is aimed at making available the experience of gestation to those for whom it may otherwise be out of reach. Given the personal and social importance of this experience to many people, this is a laudable goal. Outside of at least one historic outlier, this practice has primarily been discussed in the context of resolving uterine factor infertility (UFI) for cisgender women. The guidelines and protocols that have been established around UTx understand Uterine Factor Infertility (UFI) as the indication for UTx. This article critically evaluates the Montreal Criteria (2012, 2013) as the primary ethical guidelines regarding UTx. This evaluation focuses on and challenges the way the Criteria structure the discussion around UFI as indication for UTx and the requirement for female genetics. I argue that, outside of the initial experimental design of UTx, there are prima facie grounds for making UTx available outside of the indication of UFI, and that for reasons both internal and external to the Montreal Criteria’s analysis of UTx, there are no overwriting ethical reasons to limit UTx to cis-gender women.

Normothermic Regional Perfusion remains an ethically controversial approach to organ procurement. In response to an organizational request, we convened a Community and Professional Task Group to provide guidance on the ethical elements of this process to inform potentially forthcoming policy and practice guidelines. In this paper, we share the mechanism of forming the Community and Professional Task Group within our broader ethics consultation system, the process of information gathering, as well as the guidance that was delivered to the organization. This includes the identification of and steps for addressing the ethical issues that continue to mark NRP as an ethically complex approach to organ procurement, including those around the Uniform Determination of Death Act, the Dead Donor Rule, and public perception of and trust in deceased organ donation.

In 1971, two years before Roe v. Wade affirmed federal protection for abortion, Judith Jarvis Thomson attempted to demonstrate the wrongs of forced gestation through analogy: you awake to find that the world's most esteemed violinist is wholly, physically dependent on you for life support. Here, the authors suggest that Thomson's intuition, that there is a relevant similarity between providing living kidney support and forced gestation, is realized in the contemporary practice of living organ donation. After detailing the robust analogy between living kidney donation and gestation, we turn to current ethical guidelines incorporated in the United Network for Organ Sharing's requirements for legally authorized organ donation and transplantation. We conclude that if, as we—and Thomson—suggest, organ donation and gestation are relevantly similar, then the ethical framework supporting donation may aid in articulating ethical grounds that will be compelling in informing the legal grounds for a defense of abortion.