随着外科手术技术的进步，免疫抑制治疗的发展，以及器官活性维持手段的改进，接受器官移植患者的生存率大大提高。器官移植已经成为挽救器官衰竭患者的重要手段。然而，我国器官移植事业一直面临着两大挑战，一是公民逝世后器官捐献率低，长期存在器官供需之间的鸿沟；二是作为稀缺的卫生资源，公民逝世后捐献器官的公正分配问题。如何分配能够使捐献的器官得到最佳使用，并且能够公平公正地进行器官的分配，这不仅是器官分配伦理学问题讨论的出发点，也是全社会关注的焦点。本论文主要讨论器官分配的伦理学问题。

本论文首先对国际社会目前器官分配实践的伦理学争论进行梳理和分析，包括对按支付能力进行分配、按患者对社会的贡献、患者的行为和体质进行分配、按地理条件进行分配、按患者年龄进行分配，以及按患者医疗受益或净受益进行分配的实践进行分析。在此基础上论文提出了评价器官分配标准的伦理学框架，论证器官分配应该遵循的伦理原则包括“效用”、“公正”和“尊重”。论文还对伦理原则之间可能产生冲突的解决方法进行了论证。最后论文对我国器官分配标准（包括区域优先、等待时间优先、医疗紧急度优先、儿童优先、二次移植、不良生活方式）中的伦理问题进行了分析和研究。

With the advances of surgical technique, the development of immunosuppressive therapy and improvement of maintaining the function of organ, the survival rate of recipients after organ transplantation has been greatly escalated. Organ transplantation has become an important strategy for patients with organ failure. However, low rate of organ donation after citizen’s death and short supply of available transplantable organs were still problems for organ transplantation in China. How to improve organ donation rate has been a critical issue. Same important is as scare health resources, how to allocate the organs donated after citizen’s death, and whether the allocation is the best use and fair. This paper will focus on the organ application issue.

This paper first conducts ethical analysis of current practices of organ allocation from international perspective, including the allocation of organ by the ability to pay, merit, geography, age and medical benefit or net benefit. On the basis of this analysis the paper discusses the ethical principles of organ allocation, argues that the ethical principles of organ allocation should include utility, justice and respect for person, and proposed the resolution of conflict between these principles. Finally the paper discusses the ethical issues in the criteria of organ allocation (including priority putting on region, waiting time, medical urgency, children, second transplantation and unhealthy life styles in mainland China.