Assessing elements of informed consent among living donors

Area of Science:

• Transplantation Medicine
• Bioethics
• Surgical Oncology

Background:

• Living organ donors undertake medical risks for recipients' benefit.
• Informed consent is a primary ethical justification for living organ donation.
• Assessing the quality of informed consent in living donors is critical.

Purpose of the Study:

• To evaluate the depth of understanding and degree of voluntariness in living organ donors.
• To identify factors influencing donor decision-making and consent validity.

Main Methods:

• Retrospective survey of 262 living kidney donors, 2-40 months post-donation.
• Assessed understanding of donation outcomes, risks (short-term, long-term, psychological, financial), and voluntariness.
• Analyzed factors affecting the decision to donate again.

Main Results:

• Over 90% understood recipient outcomes, screening, and short-term risks.
• Understanding of psychological (69%), long-term medical (52%), and financial (32%) risks was lower.
• 40% reported pressure to donate, with related donors experiencing more pressure.
• Understanding recipient outcomes was the sole factor influencing re-donation decisions.

Conclusions:

• Significant gaps exist in living donors' understanding of psychological, long-term medical, and financial risks.
• Perceived pressure to donate, particularly among related donors, raises concerns about voluntariness.
• Further research is essential to enhance informed consent processes and ensure donor autonomy.