Lung transplantation is now an accepted therapeutic option for many pa
tients with incurable end-stage lung or pulmonary vascular disease pro
cesses for which other treatment options have been expended. However,
as lung transplantation has evolved as a recognized discipline over th
e past decade, a variety of ethical issues related to the transplant p
rocess are emerging. This article considers those issues through a dis
cussion of the four fundamental principles of biomedical ethics.