Considering the issue of organ donation and transplantation, the respect for autonomy is the right to choose for the decision making of certain biomedical ethical dilemma. It not just involves giving respect for the attitude, but also for the action to be performed. From pure secular ethics point, we can relate what Immanuel Kant had recognized from the concept of unconditional worth, stating that each individual has the capacity to determine his or her own moral destiny. To violate a person’s autonomy is like treating that person merely as means, without regard to that person’s own goals. Example if a person s dead and his organs are taken from his body without his previous advance directives of any such act, then, it’s again considered to be using that body as a means. But what if that organ was so precious in saving the life of a living person, who could have benefitted humanity if given a chance to live, e.g. a doctor or a well trained militant, etc. this shows the beneficence over the autonomy and serving the utilitarian ethical principle. If we consider the case of organ taken from a fetus, then again who is the ultimate supreme authority to give consent on behalf of that minor? What makes one decides the ruling of a certain act to be just for an individual? Then here comes the question of, who plays the role of the unquestionable evaluator and who among us is eligible to be devoid of all flaws in reasoning and decision making? Does the living donor has the ultimate right over his body or his relatives who have the right to decide the answer to this if another influential family member is the supposed recipient of the organ? A wife cannot take decision over her own medical issues without her husbands’ will and consent? A poor clan member of a certain tribe falls victim to the Jirga rulings. Similarly what happens to the war prisoners? The freedom fighters in occupied areas, who have been mutilated for organ trafficking? Who plays the role of just decision making and for what principle? Is it justified that “Greatest happiness Principle” is fulfilled by the Utilitarian approach? Kantian approach, a duty to save human life? Egalitarian approach, to get equal benefit? Communitarian to serve the community benefits at the cost of one’s own necessities and health. The questions remains open ended, if we try to rebut the argument with one ethical principle, then the other might get offended. Does virtue ethics answers every thing?