Lainie Friedman Ross M.D., Ph.D.

Co-Director of the Institute of Translational Medicine
Associate Director of the MacLean Center for Clinical Medical Ethics
Carolyn and Matthew Bucksbaum Professor of Clinical Ethics
The University of Chicago
Email: lross@uchicago.edu Discipline: Medicine, Ethics Expertise: Ethical Dilemmas and Allocation of Resources, Disparities, Genetics

Investigator Award

A Case-Based Approach to the Ethical and Policy Issues Raised by Living Donor Transplantation
Award Year: 2013 The purpose of the research is to explore the ethical and policy issues raised by transplantation with living donors. While the major ethical and policy issues in living donor transplantation depend, in part, upon the organs and tissues being procured, there are certain cross-cutting themes that relate to any living organ or tissue procurement, including: 1) the moral agency of living donors and their prospective recipients; 2) how much risk living donors should be allowed to take; 3) what informed consent means and requires in the context of living donation; 4) the limits to privacy and confidentiality between living donors and recipients; 5) whether and when members of vulnerable populations can serve as living donors; 6) the moral limits to donor recruitment; 7) whether there should be restrictions on who can receive a live donor organ or tissue; 8) public policy regarding payments to donors, whether for expenses or as incentives; and 9) justice issues and disparities in living donor transplantation. This project will explore these themes using case studies. Our use of case studies is innovative because we seek to bridge the gap between ethical theory and clinical practice to reform living donor transplant policy, an area relatively neglected and lacking much regulatory oversight. The case study format will allow us to engage the myriad of stakeholders involved in living donor transplantation decisions. We will use cases and an analytical framework based on respect for persons in a process of “reflective equilibrium” in which one works back and forth between one’s moral intuitions and judgments with the particularities of the case to identify the principles or rules that explain one’s judgments, revising the judgments or principles whenever necessary in order to achieve an acceptable coherence among them. This approach uses analytical moral philosophy responsive to the clinical facts and the social and historical context, with the aim of creating a morally sound, clinically useful framework that provides guidance in transplant practice and policy development and refinement. The principal product of the research will be a book analyzing over two dozen cases.

Background

Lainie Friedman Ross is the Carolyn and Matthew Professor of Clinical Ethics at the University of Chicago where she is a practicing pediatrician, an associate director of the MacLean Center for Clinical Medical Ethics, and the co-director of the Institute of Translational Medicine.  She received her undergraduate degree from the Woodrow Wilson School of Public and International Affairs at Princeton University in 1982, where she was influenced by the late Paul Ramsey to pursue controversial questions raised by children in medical research.  She obtained her medical degree at the University of Pennsylvania School of Medicine in 1986 and her PhD in philosophy at Yale University in 1996, where she worked with the late Jay Katz whose work on vulnerable populations was very instrumental in her own research agenda.  

Dr. Ross’ research focuses on three topics: ethical and policy issues in pediatrics, ethical and policy issues in organ and tissue transplantation, and ethical issues in genetic testing and screening. Dr. Ross has written extensively in scholarly journals and has authored two books - Children, Families and Health Care Decision Making [1996] and Children in Research: Access versus Protection [2006] - both published by Oxford University Press.  She is currently writing Transplantation Ethics (2nd edition) with Robert Veatch, which will be published by Georgetown University Press in 2014.  

Dr. Ross has served as a member of several national committees, including the DHHS Secretary’s Advisory Committee on Human Research Protections (SACHRP), the American Academy of Pediatrics Committee on Bioethics, the Institute of Medicine Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule, the American College of Medical Genetics and Genomics Social, Ethics and Legal Issues Committee, and the United Network for Organ Sharing (UNOS) Ethics Committee.  She is currently the chair of the Executive Committee of the Section on Bioethics of the American Academy of Pediatrics.