President’s address to the American Society of Transplant Surgeons (ASTS)
Winter Symposium, January 14, 2016.
Charles M. Miller, President
Full speech is available for viewing at 

Beauty and the Beast
Part 2 of 2

Altruism: A Core Value in the Field of Transplantation
charlie_1bSo those are [some] of the specific initiatives that make up this evolving strategy. But what do we use to hold this strategic initiative together; what is the glue that keeps us focused and moving in the right direction? My answer to the question is our Core Values that we live and work with. And I wanted to focus on a Core Value central to transplantation; that is altruism. It is interesting to consider that altruism is the requisite catalyst for every single transplant we do. That single fact creates a stark contrast to almost all other transactions in our media driven world where egoism, the direct opposite of altruism, seems to Trump all; sorry for the pun!

Most of miller quote boxthe transplant literature regarding altruism appropriately revolves around donors. Deceased donors, donor families and living donors alike, selflessly volunteer to make life-giving gifts to others, known or unknown, with no real identifiable benefit except the personal satisfaction of helping another. It is truly remarkable. But I want to challenge all of us to look at altruism in a much broader and simplistic way than most bioethicists and medical anthropologists commonly do.

If we are to be successful, donor altruism is first and foremost, and must be recognized, respected and supported.  I would argue that we need to promote the value of altruism in transplantation in a way that extends beyond purely the donors. It needs to be a Core Value that guides how we treat one another, both within the ASTS and throughout the Transplant Community.  In order to truly honor our donors, we need to recognize that altruism in transplantation must be promoted and incorporated in the work we do every day and we must set an example for the providers, administrators, policy makers, regulators and the media.

There are many other simple and generous ways to express altruism. For example, we [might] better help each other with donor procurements to save each other time, effort and cost as well as avoid the well-known risk of air charters. Or, we [might] figure out more liberal ways to split livers that makes grafts easier and better to share for both your and your colleagues’ patients.

No matter how far we eventually go, altruism will remain the cornerstone of donation and transplantation, and we must incorporate that value into our professional lives as never before; we must walk the walk, as well as talk the talk.

In many denominations of religious and philosophical writings, the words “altruism” and “love” are used synonymously. And to segue back to our little fairy tale, the only thing the Beast had to learn in order to be transformed back to a Prince was to learn how to love. But can we explore pastures beyond pure altruism. What will it take to utilize positive incentives once all disincentives to donation are removed?

Well to try and answer that question, let me segue from Beauty and the Beast- altruism and love to Jim Collins’ book, [Built to Last, which focuses on] those things that successful companies have in common.

The overarching theme is the importance of Core Values. As important as a good business plan is to a company, the great and enduring companies have both a good plan and a clearly enunciated set of Core Values that guide how they work on the plan every day.

We need as a Society a well-thought-out charlie 2band clearly enunciated set of Core
Values that guide us. Make no mistake about it, when the time comes to explore incentives beyond pure altruism there will be harsh and loud critics; some with absolute religious zeal. We cannot be defensive. We must be prepared and armed with our own set of Core Values to gain the ethical high ground. So I tell you today that I will make the discussion and promulgation of ASTS Core Values a priority for the remainder of my presidency, for they will be the fuel, the glue and the armor needed to make our Strategic Plan successful.

Collectively, we can affect change.  The ASTS is a big team whose members are fully committed to improving the field. We’re trying to get it right by focusing on our Strategic Plan. And it is only through your ideas, dedication, passion, expertise and hard work that we can make real change.

When I look out from here, I see a vibrant and eager group looking to help and looking to lead; and when we work together we can really effectuate positive change for our patients and donors who always continue to inspire. And this is why today; I feel such pride – pride in our field and pride in you, our Members and friends.

And so today, I am more optimistic in our future than ever before. And through our adherence to our Strategic Plans and Core values, our work will be transformative and bring new promise to our patients and to the field.