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    Area of Science:

    • Medical Ethics
    • Transplantation Surgery
    • Prisoner Rights

    Background:

    • National guidelines exist for living donor evaluation and informed consent.
    • No specific protections are currently in place for incarcerated individuals as potential living donors.
    • Prisoners in the United States are afforded special protections under Federal Regulations (45 CFR 46) due to their vulnerable status.

    Purpose of the Study:

    • To identify and describe the special considerations needed for incarcerated individuals as potential living organ donors.
    • To adapt a vulnerabilities approach from human research subject protection literature for this specific population.
    • To advocate for ethical and equitable treatment of prisoners in the context of living donation.

    Main Methods:

    • Review of existing national guidelines for living donor transplantation.
    • Analysis of Federal Regulations (45 CFR 46) concerning prisoner protections in research.
    • Application of a vulnerabilities framework, commonly used in human subject research, to the context of living organ donation by incarcerated individuals.

    Main Results:

    • Living donor transplantation shares ethical parallels with human subject research due to the primary benefit to a third party.
    • A vulnerabilities approach highlights the need for tailored protections for incarcerated potential donors.
    • Specific considerations should address potential coercion, autonomy, and post-donation care within the carceral system.

    Conclusions:

    • Incarcerated individuals as living donors represent a vulnerable population requiring enhanced ethical safeguards.
    • Existing human research protection frameworks can be adapted to ensure the rights and welfare of prisoners undergoing living donation.
    • Implementing these special considerations is crucial for ethical and equitable living donor transplantation practices.