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Can we turn down autonomous wishes to donate anonymously?
Medard Hilhorst1, Henri Wijsbek, Ruud Erdman
1Medical Ethics and Philosophy, Erasmus University Medical Centre, Rotterdam, The Netherlands. m.hilhorst@erasmusmc.nl
Summary
Altruistic donors may offer multiple organs, but transplant centers must ethically evaluate risks and motivations. Refusal requires sound moral reasoning, not judgment of relationships or donor life goals.
Area of Science:
- Transplantation Medicine
- Bioethics
- Organ Donation
Background:
- Samaritan living donors can offer organs anonymously.
- Donors may express a wish to donate multiple organs sequentially.
- Transplant centers face ethical dilemmas regarding donor wishes.
Purpose of the Study:
- To evaluate the ethical considerations of a living donor wishing to donate a second organ (liver) after a previous kidney donation.
- To assess common arguments for refusing such donations.
- To determine criteria for ethically evaluating and potentially refusing repeated altruistic organ donation.
Main Methods:
- Review of ethical arguments for and against accepting repeated altruistic organ donations.
- Assessment of the strengths and weaknesses of common refusal rationales.
- Analysis of donor competence, voluntariness, and informed consent.
Main Results:
- Donor's wish was informed, voluntary, and competent.
- Refusal requires sound moral reasons, which are not always clear.
- Assessing risks and motivations is crucial, not judging relationships.
Conclusions:
- Transplant centers should focus on objective risks and donor motivations, not personal relationships.
- A donor's life project or personal goals should not dictate donation decisions.
- Ethical frameworks are needed to guide decisions on repeated altruistic organ donation.
Related Concept Videos
01:03Altruism
Altruistic behaviors are “unselfish” behaviors—those that help another individual at the expense of the individual carrying out the behavior. Despite the negative consequences for the altruistic animal, these behaviors are thought to have evolved for several reasons.
01:55Egoism and Altruism
Voluntary behavior with the intent to help other people is called prosocial behavior. Why do people help other people? Is personal benefit such as feeling good about oneself the only reason people help one another?
01:52Persuasion Strategies
Researchers have tested many persuasion strategies, including the foot-in-the door and the door-in-the-face techniques, in a variety of contexts. Ultimately, the principles are effective in selling products and changing people’s attitude, ideas, and behaviors (Cialdini & Goldstein, 2004).
02:34Empathy
Some researchers suggest that altruism operates on empathy. Empathy is the capacity to understand another person’s perspective, to feel what he or she feels. An empathetic person makes an emotional connection with others and feels compelled to help (Batson, 1991). Empathy can be expressed in several ways, including cognitive, affective, and motor.
00:57Deindividuation
Deindividuation is a form of social influence on an individual’s behavior such that the individual engages in unusual or non-normal behavior while in a group setting. Why? Because in these group settings, the individual no longer sees themselves as an individual anymore, disinhibiting their behavior and personal restraint.
02:45Self-Discrepancy Theory
One influential perspective on what motivates people's behavior is detailed in Tory Higgin's self-discrepancy theory (Higgins, 1987). He proposed that people hold disagreeing internal representations of themselves that lead to different emotional states.