With a shortage of organs for transplantation purposes, many ethical issues confront registered nurses, particularly those involved in making difficult allocation and rejection decisions and those who interact with people who are not successful in gaining a needed organ for survival. This is a theoretical paper aimed at justifying the need for research investigations on moral distress in relation to organ donation and transplantation. Given the caring nature of nurses and the widespread impact of the shortage of organs for transplantation purposes, moral distress is likely to be present and growing in both incidence and severity