A Diminishing Dilemma

Medical progress has a way of resolving ethical dilemmas. Cesarean section and improved obstetrical management have largely eliminated the need for choosing between the dread alternatives of a dead mother or a dead baby. Mass production of synthetic antibiotics has obviated the necessity of selecting few recipients from the many in need of a lifesaving drug. Improvement in prosthetic devices for the disabled has made it possible for families to select care in the home rather than in an institution. Use of baboons¹ in cross-cirulation for hepatic coma promises to bypass the forbidding ethical deterrent in considering human donors.

The important ethical dilemma of choosing between living human donors and cadavers for kidney transplantation also appears to be on its way toward resolution. This choice was not possible in 1954 when the Boston team of Murray and coworkers performed the first renal transplant from a living identical twin. Only