Table 3 Ethical issues related to COVID-19 pandemic and OTDT and CBS ethical principles

General ethical issues and challenges reported by OTDT organizations and transplantation programs

Risk of COVID-19 transmission to transplant recipients

Safety and security, ethical practices in OTDT (non-maleficence and respect for persons)

Risk of COVID-19 exposure and infection to healthcare professionals during the transplant process

Safety, accountability, cost-effectiveness

Risk of waitlist mortality or further resource strain where transplants are halted

Safety, accountability, cost-effectiveness, ethical practices (non-maleficence)

Resource allocation

Safety, fairness, cost-effectiveness, ethical practices in OTDT (utility, non-maleficence, beneficence), population-based

Ethical challenges related to informed consent for OTDT

Informed consent in the context of uncertainty

Safety, accountability, fairness, ethical practices in OTDT (respect for autonomy and beneficence)

Virtual consent

Fairness, ethical practices in OTDT (respect for autonomy), privacy, and accountability

Ethical issues related to organ allocation

Fairness, safety, population-based system, ethical practices in OTDT (justice, non-maleficence)