Transplantation programs commonly rely on clinicians' judgments about patients' social support (care from friends or family) when deciding whether to list them for organ transplantation. We examine whether using social support to make listing decisions for adults seeking transplantation is morally legitimate, drawing on recent data about the evidence-base, implementation, and potential impacts of the criterion on underserved and diverse populations. We demonstrate that the rationale for the social support criterion, based in the principle of utility, is undermined by its reliance on tenuous evidence. Moreover, social support requirements may reinforce transplant inequities, interfere in patients' personal relationships, and contribute to biased and inconsistent listing procedures. As such, accommodating the needs of patients with limited social support would better balance ethical commitments to equity, utility, and respect for persons in transplantation. We suggest steps for researchers, transplantation programs, and policymakers to improve fair use of social support in transplantation.

中文翻译：

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缺乏社会支持会阻止器官移植吗？

移植程序通常在决定是否列出要进行器官移植的患者时，取决于临床医生对患者社会支持（来自朋友或家人的护理）的判断。我们使用社会支持为寻求移植的成年人做出上市决定是否在道德上是合法的，并利用有关该标准对服务不足和多样化人群的证据基础，实施和潜在影响的最新数据。我们证明，基于效用原则的社会支持标准的基本原理因其依赖于不充分的证据而受到破坏。此外，社会支持的要求可能会加剧移植不平等现象，干扰患者的人际关系，并助长有偏见和不一致的挂牌程序。因此，在社会支持有限的情况下满足患者的需求将更好地平衡对公平，实用性和对移植患者的尊重的道德承诺。我们建议研究人员，移植计划和政策制定者采取步骤，以改善对移植中社会支持的合理利用。