Media appeals for directed altruistic living liver donations: lessons from Camilo Sandoval Ewen

Recently, a Canadian couple sought media help to find a person who was willing to donate part of his or her liver to their infant son, Camilo Sandoval Ewen, who suffered from biliary atresia. Although Canadian transplant programs do not perform transplants from non-emotionally related living donors, they are accepted by some U.S. transplant centers, particularly when donated in a nondirected fashion. This paper examines the ethical questions raised by media appeals for directed altruistic living donations of solid organs, specifically liver lobes, and argues that media-directed altruistic donations are ethically problematic. While they can and do succeed, they raise ethical concerns regarding (1) who has access to the media; (2) who will be successful in their media campaigns; and (3) how coercion and inducement by brokers (families or institutions) can be prevented. Justice requires that the media adopt a policy not to cover organ appeals by families, despite their human interest value, and that transplant centers develop a unified policy restricting directed living donations to those who have an emotional relationship.