World Medical Association, Declaration on Human Organ Transplantation (1987)

Adopted by the 39th World Medical Assembly Madrid, Spain, October 1987


The World Medical Association recommends the following guidelines for the guidance of physicians engaged in the transplantation of human organs.
1. The primary concern of physicians must at all times be the health of their patients. The concern and allegiance must be preserved in all medical procedures, including those which involve the transplantation of an organ from one person to another. Both donor and recipient are patients and care must, therefore, be taken to protect the rights of both. No physician may therefore assume a responsibility in organ transplantation unless the rights of both donor and recipient are protected.
2. A potential organ transplant offers no justification for a relaxation of the usual standard of medical care. The same standard of care should apply whether the patient is a potential donor or not.
3. When an organ is to be transplanted from a donor after the donor's death, the death of the donor shall have been determined independently by two or more physicians who are not involved in the transplantation procedure. Death shall be determined by the judgement of each physician. In making this determination, each physician will use currently accepted scientific tests, and criteria that are consistent with the ethical requirements and professional standards established by the National Medical Association and other appropriate medical organizations in the community.
4. Whenever an experimental procedure such as the transplantation of animal organs or artificial organs is being considered, the physician should comply with the recommendations contained in the World Medical Association's Declaration of Helsinki, providing guidance for physicians in biomedical research involving human subjects.
5. The fullest possible discussion of the proposed procedure with the donor and the recipient or their respective responsible relatives or legal representatives is mandatory. The physician should be objective in discussing the procedure, in disclosing known risks and possible hazards, and in advising of the alternative procedures available. The physician should not encourage expectations beyond those which the circumstances justify. The physician's interest in advancing scientific knowledge must always be secondary to his primary concern for the patient. Free informed consent must always be obtained.
6. Transplant procedures of body organs should be undertaken:
(a) only by physicians who possess special medical knowledge and technical competence developed through special training, study and practice, and
(b) in medical institutions with adequate facilities for organ transplantation.
7. Transplantation of body organs should be undertaken only after careful evaluation of the availability and effectiveness of other possible therapy.
8. The purchase and sale of human organs for transplantation is condemned.