IntroductionSplit liver transplantation (SLT) allows two recipients, in current practice usually an adult and a child, to benefit from one deceased donor liver. Recent comprehensive studies confirm that split liver transplants generally lead to less favorable results for individual recipients, but also lead to more individuals getting the benefit of a liver transplant. Surgeons' pioneering advances in the operating room have left a classic ethical dilemma in their wake: where and how should the transplant community draw a balance between the rights and interests of patient A (an adult recipient), who is at the top of the transplant list, and patient B (most likely a pediatric recipient), who is somewhere down the list and will get a timely liver transplant if and only if patient A shares the donor liver. The purpose of this essay is to explore this difficult issue and also to propose general ethical and policy guidelines for the use of split liver transplants vis-à-vis whole liver transplants.

This Essay criticizes the proposed Federal Marriage Amendment as inconsistent with the principle of federalism. It argues that after recent Supreme Court decisions on the rights of gays, it is likely that federal and state laws discriminating against the recognition of same-sex marriages are likely to be found unconstitutional. It then argues that a constitutional amendment defining marriage is inconsistent with the purposes behind our federal system of government, and that a more preferable approach would preserve to each state the ability to define marriage for itself.