Serial Living Solid Organ Donation: An Ethical Analysis.

Area of Science:

• Medical Ethics
• Transplantation Surgery
• Public Health

Background:

• Serial living organ donation involves individuals donating a second organ (e.g., kidney then liver lobe) after an initial donation.
• While single organ donation ethics are established, serial donation's ethical landscape remains largely unexplored.
• Key ethical principles include respecting donor autonomy, beneficence, and non-maleficence.

Purpose of the Study:

• To conduct an ethical analysis of serial living solid organ donation using Principlism.
• To identify and examine the unique ethical challenges posed by serial organ donation compared to single donation.

Main Methods:

• Ethical analysis utilizing the framework of Principlism.
• Review of existing ethical considerations for single organ donation and their application to serial donation.

Main Results:

• Serial donation intensifies ethical issues of single donation, particularly concerning donor autonomy due to uncertain long-term risks and increased coercion potential.
• Non-maleficence is challenged by heightened surgical risks from prior surgery.
• Beneficence outcomes are unknown, and pathological altruism emerges as a novel ethical concern threatening all core principles.

Conclusions:

• Long-term physical and psychological risks of serial donation require research to uphold ethical principles.
• Increased understanding of pathological altruism in living organ donors is crucial.
• Enhanced psychological assessments are needed to detect potentially harmful motivations in serial donors.