Duties to stakeholders amidst pressures from shareholders: lessons from an advisory panel on transplant policy.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 8704792 Publication Model: Print Cited Medium: Print ISSN: 0269-9702 (Print) Linking ISSN: 02699702 NLM ISO Abbreviation: Bioethics

Publication: Oxford : Wiley-Blackwell
Original Publication: Oxford ; New York : Basil Blackwell, c1987-

Health Policy* ; Patient Selection* ; United States Dept. of Health and Human Services*; Advisory Committees/*organization & administration ; Health Care Rationing/*organization & administration; Community Participation ; Consensus ; Health Care Rationing/ethics ; Humans ; Policy Making ; Socioeconomic Factors ; Tissue and Organ Procurement ; United States

The distinction between stakeholders and shareholders frequently employed in business ethics can illuminate challenges faced by a bioethics advisory panel. I use the distinction to reflect back on the work of an advisory panel on which I served, a panel on US transplant policy. The panel hearings were akin to a shareholders' meeting, with many stakeholders absent. In addition to 'hearing out' the shareholders who were present, the panel had duties to absent stakeholders to insure their interests were included in public discussion. While panel efforts to include stakeholder perspectives rightfully framed its report, such duties should have framed its operating procedures more robustly. The stakeholder/shareholder distinction also offers a critical prism on the actual evolution of organ allocation policy, which the panel failed to influence. Current policy embodies a compromise among shareholders that obscures major stakeholder interests. This results in under-attention to likely medical benefit of transplant, compared to other allocation criteria. Recognition of duties to stakeholders amidst pressures of shareholders complicates the notion of 'consensus' for an advisory panel. Consensus framed on terms defined only by shareholders, not stakeholders, may be an inadequate measure of public interest.

Indexing Agency: KIE Local ID #: 110449.
Keywords: Analytical Approach; Health Care and Public Health; United Network for Organ Sharing*
Note: 18 fn. Note: KIE Bib: ethicists and ethics committees; organ and tissue transplantation; resource allocation/biomedical technologies; selection for treatment

Date Created: 20031022 Date Completed: 20031028 Latest Revision: 20191108

20240628

10.1111/1467-8519.00348

14567390