RAISING THE DEAD

One man’s take on the art, science, and ethics of organ transplantation. Given the author’s other life as a thriller writer (Night Vision, 1995, etc.), it’s not too surprising that the take is often as melodramatic as the title.

The facts are mostly here, however, and textbook-writer Munson (Philosophy of Science and Medicine/Univ. of Missouri, St. Louis) provides a useful review of where we’ve been and what lies ahead. Remember Mickey Mantle’s liver transplant? Foil for Munson’s discussion of whether it’s right to give lifelong alcoholics—with liver cancer yet—a transplant, and whether the rich and famous get put at the top of the list. Baby Fae with the baboon heart? Basis for examination of xenotransplantation (cross-species transplants). And so with a consideration of the ethics of selling organs, touched off by the story of a woman who donated a kidney to finance her son’s bone-marrow transplant. Munson also supplies such future scenarios as entrepreneurs raising baboons for transplants, or all of us to growing replacement organs based on harvesting our own stem cells. Each of these chapters (as well as several on the issue of defining when death occurs) ends with the bioethicist taking a stand on what’s right or wrong. Munson concludes that the docs did the right thing in Mantle’s case, the wrong one in Baby Fae’s; he says it’s sometimes okay to sell organs and comments that xenotransplants may have more going for them than against (such as the risk of spreading animal viruses). Finally, he sees real hope for embryo and, to a lesser extent, adult stem-cell therapy, opposing the Catholic (and Bush administration) position that only existing embryo stem-cell lines should be available for research.

Readers will certainly not agree with Munson in all cases, but he does a service in raising the issues and pointing to the needs of an aging society in which health care is anything but equitable.