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xiii | |
Preface |
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xv | |
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1 Religious and Cultural Perspectives |
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1 | (23) |
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Defining Death and Desecrating the Corpse: Two Preliminary Issues |
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1 | (10) |
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The Two Central Ethical Issues |
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11 | (6) |
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17 | (1) |
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18 | (6) |
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2 An Ethical Framework: General Theories of Ethics |
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24 | (13) |
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Religious Ethical Approaches |
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24 | (1) |
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Secular Ethical Approaches |
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25 | (7) |
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32 | (5) |
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3 The Dead Donor Rule and the Concept of Death |
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37 | (15) |
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39 | (2) |
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Candidates for a Concept of "Death" |
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41 | (4) |
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The Public Policy Question |
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45 | (4) |
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49 | (3) |
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4 The Whole-Brain Concept of Death |
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52 | (12) |
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The Case for the Whole-Brain Concept |
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54 | (1) |
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Criteria for the Destruction of All Brain Functions |
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55 | (5) |
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Problems with the Whole-Brain Definition: The Alternatives |
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60 | (1) |
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61 | (3) |
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5 The Circulatory, or Somatic, Concept of Death |
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64 | (24) |
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Two Measurements of Death |
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65 | (3) |
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Circulatory Death and Organ Procurement |
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68 | (6) |
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Ways Around Absence of Explicit Consent |
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74 | (6) |
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80 | (3) |
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Shewmon's Somatic Concept |
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83 | (1) |
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The Two Definitions of the US President's Council on Bioethics |
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84 | (1) |
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85 | (3) |
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6 The Higher-Brain Concept of Death |
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88 | (14) |
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Which Brain Functions Are Critical? |
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89 | (4) |
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Altered States of Consciousness: A Continuum |
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93 | (2) |
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Measuring the Loss of Higher-Brain Function |
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95 | (1) |
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96 | (2) |
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The Legal Status of Death |
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98 | (1) |
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99 | (3) |
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7 The Conscience Clause: How Much Individual Choice Can Our Society Tolerate in Defining Death? |
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102 | (21) |
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The Present State of the Law |
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103 | (1) |
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Concepts, Criteria, and the Role of Value Pluralism |
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104 | (4) |
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Explicit Patient Choice, Substituted Judgment, and Best Interest |
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108 | (2) |
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Limits on the Range of Discretion |
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110 | (1) |
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The Problem of Order: Objections to a Conscience Clause |
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111 | (7) |
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Implementation of a Conscience Clause |
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118 | (1) |
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119 | (1) |
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119 | (4) |
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8 Crafting a New Definition-of-Death Law |
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123 | (8) |
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Incorporating the Higher-Brain Notion |
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123 | (1) |
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124 | (1) |
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Clarification of the Concept of "Irreversibility" |
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125 | (1) |
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A Proposed New Definition of Death for Public Policy Purposes |
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126 | (1) |
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126 | (1) |
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127 | (4) |
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131 | (16) |
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The Moral Foundation of the Donation Model |
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132 | (5) |
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Variations on the Donation Model |
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137 | (6) |
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The Limits of the Donation Model |
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143 | (1) |
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144 | (3) |
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10 Routine Salvaging and Presumed Consent |
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147 | (17) |
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147 | (3) |
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150 | (3) |
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The Morality of Salvaging |
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153 | (1) |
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153 | (2) |
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155 | (4) |
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159 | (1) |
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160 | (4) |
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164 | (24) |
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The World's Experience with Organ Markets |
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165 | (9) |
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The Ethics of a Market for Organs |
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174 | (6) |
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Variations on the Market Model: "Rewarded Gifting" |
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180 | (2) |
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182 | (6) |
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12 Live-Donor Transplants |
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188 | (26) |
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188 | (1) |
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Expanding Living Donors: Paired Live-Donor Exchanges and Variants |
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189 | (2) |
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The Ethics of Live Donation: Two Approaches |
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191 | (11) |
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202 | (4) |
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The Right of Persons to Become Donors |
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206 | (3) |
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209 | (1) |
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210 | (4) |
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214 | (17) |
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The Types of High-Risk Organs |
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215 | (6) |
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Should Transplant Patients Receive High-Risk Organs? |
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221 | (1) |
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Why Do Surgeons Fear High-Risk Organs? |
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222 | (2) |
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A Proposal for a Policy Change |
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224 | (2) |
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226 | (5) |
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14 Xenotransplants: Using Organs from Animals |
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231 | (20) |
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The History of Xenotransplantation |
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232 | (2) |
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Special Ethical Problems Raised by Xenotransplantation |
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234 | (12) |
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246 | (1) |
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247 | (4) |
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15 The Media's Impact on Transplants and Directed Donation |
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251 | (20) |
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Direct Media Solicitation by Individuals for a Deceased Donor |
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252 | (3) |
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The Media and Living Directed Donation |
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255 | (4) |
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Living versus Deceased Directed Media Appeals |
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259 | (1) |
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260 | (3) |
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The Media and Transplant Programs |
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263 | (1) |
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264 | (1) |
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264 | (7) |
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PART III ALLOCATING ORGANS |
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16 The Roles of the Clinician and the Public |
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271 | (13) |
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The Clinician and Allocation |
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271 | (2) |
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Allocation as a Moral Rather Than Technical Matter |
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273 | (5) |
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The Role of the Public in Allocation |
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278 | (2) |
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280 | (2) |
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282 | (2) |
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17 A General Moral Theory of Organ Allocation |
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284 | (22) |
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Social and Medical Utility |
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285 | (6) |
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291 | (7) |
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298 | (3) |
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301 | (1) |
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302 | (4) |
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18 Voluntary Risks and Allocation: Does the Alcoholic Deserve a New Liver? |
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306 | (15) |
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The Theory of Voluntary Health-Risky Behavior |
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306 | (6) |
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Alcohol and Liver Transplants |
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312 | (3) |
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The Role of a History of Alcoholism in Allocation Policy: Four Options |
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315 | (2) |
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Other Voluntary Behaviors |
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317 | (2) |
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319 | (2) |
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19 Multi-Organ, Split-Organ, and Repeat Transplants |
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321 | (13) |
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322 | (3) |
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325 | (4) |
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Splitting Organs and Combining Organs |
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329 | (2) |
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331 | (3) |
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20 The Role of Age in Allocation |
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334 | (21) |
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The Moral Norms for Allocation |
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334 | (5) |
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339 | (1) |
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Allocation to Older Persons |
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340 | (1) |
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New Formulas for Taking Age into Account |
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341 | (10) |
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Over-a-Lifetime Need versus Present Need |
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351 | (1) |
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351 | (4) |
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21 The Role of Status: The Cases of Mickey Mantle, Robert Casey, Steve Jobs, and Dick Cheney |
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355 | (12) |
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Mickey Mantle and Liver Priority |
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355 | (4) |
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359 | (1) |
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360 | (1) |
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361 | (1) |
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Social Worth versus Social Status |
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362 | (3) |
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365 | (2) |
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22 Geography and Other Causes of Allocation Disparities |
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367 | (26) |
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The Role of Geography in Allocation |
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368 | (5) |
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The Reasons for Local Priority |
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373 | (3) |
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The Demand for a National List |
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376 | (4) |
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The Ethics of the Conflict over Geography |
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380 | (3) |
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Did the Final Rule Achieve Equity? |
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383 | (4) |
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387 | (6) |
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23 Socially Directed Donation: Restricting Donation by Social Group |
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393 | (16) |
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Two Examples of Socially Directed Donation |
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393 | (2) |
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The Concept of Socially Directed Donation |
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395 | (1) |
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Moral Arguments about Socially Directed Donation |
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395 | (4) |
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The Inadequate Case for the Maximin |
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399 | (2) |
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Egalitarian Justice as a Prima Facie Principle |
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401 | (3) |
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The True Egalitarian Alternative |
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404 | (1) |
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405 | (1) |
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405 | (4) |
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24 Elective Organ Transplantation |
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409 | (8) |
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If Liver Grafts Were Not Scarce |
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410 | (1) |
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Elective Liver Transplantation |
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410 | (3) |
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Do Numbers of Organs Count? |
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413 | (1) |
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414 | (1) |
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415 | (1) |
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415 | (2) |
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25 Vascularized Composite Allografts: Hand, Face, and Uterine Transplants |
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417 | |
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418 | (3) |
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421 | (9) |
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An Update on UNOS Policy and Procedures Regarding VCAs |
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430 | (1) |
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431 | (1) |
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431 | (4) |
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435 | |