Penn Bioethics Seminar (PBS): "Organ Diversion or Match Run Deviation? Ethical Considerations in Allocation Out of Sequence" - Andrew M. Courtwright, MD, PhD

12:00pm - 1:00pm • Virtual, via Zoom

2026-01-27 12:00:00 2026-01-27 13:00:00 America/New_York Penn Bioethics Seminar (PBS): "Organ Diversion or Match Run Deviation? Ethical Considerations in Allocation Out of Sequence" - Andrew M. Courtwright, MD, PhD Organ Diversion or Match Run Deviation? Ethical Considerations in Allocation Out of Sequence Andrew M. Courtwright, MD, PhD Clinician, Division of Pulmonary Medicine Adjunct Professor, University of Utah Department of Philosophy University of Utah Health The rise of Allocation Out of Sequence (AOOS) in organ transplantation in the United States has raised significant ethical concerns. By the end of 2024, 20% of kidneys were transplanted out of the standard match sequence, drawing regulatory scrutiny. Critics argue that AOOS amounts to organ diversion: it fails to prevent organ nonuse, does not address underlying inefficiencies in organ allocation, lacks transparency, and worsens transplant-related disparities. In this talk, Dr. Courtwright discusses the factors contributing to the expansion of AOOS and evaluates the normative arguments for and against its use. Drawing on a constructivist framework, he argues that AOOS violates the expectation that allocation policies be grounded in collective agreement. Dr. Courtwright identifies considerations that should inform Organ Procurement and Transplantation Network policy revisions, emphasizing the need for shared norms to ensure procedural legitimacy. Virtual, via Zoom Penn Medical Ethics

The rise of Allocation Out of Sequence (AOOS) in organ transplantation in the United States has raised significant ethical concerns. By the end of 2024, 20% of kidneys were transplanted out of the standard match sequence, drawing regulatory scrutiny. Critics argue that AOOS amounts to organ diversion: it fails to prevent organ nonuse, does not address underlying inefficiencies in organ allocation, lacks transparency, and worsens transplant-related disparities.

In this talk, Dr. Courtwright discusses the factors contributing to the expansion of AOOS and evaluates the normative arguments for and against its use. Drawing on a constructivist framework, he argues that AOOS violates the expectation that allocation policies be grounded in collective agreement. Dr. Courtwright identifies considerations that should inform Organ Procurement and Transplantation Network policy revisions, emphasizing the need for shared norms to ensure procedural legitimacy.