Ethics of Organ Donation

Abstract

The first basic principle is that all individuals can donate as well as receive an organ. A balance of all possible ethical considerations should be discussed, including transplant benefit and clinical utilitarian demand, with respect for an individual’s choice whether to donate an organ in life or after death. The increasing success of living donor transplants (above all renal transplants) is the primary justification for using living donors, which can be considered a “regrettable necessity” due to the continuing shortage of deceased donors. A full informed consent is the minimum prerequisite for an altruistic living donor, and this consent can only be obtained if the donor has a proper understanding and correct information about the risk for the donation procedure and the donor mortality rate is up to approximately 12–13 per 6,000 cases (0.2 %, including donors of left or right lobes and donors to both adult and child recipients) [1]. It is inappropriate to discuss brain death and the consequences with the patient’s family without also respecting donors and families in terms of the dignity, honesty, and authenticity of each person involved in the donation path. Criteria for the acceptance of living unrelated donors should be fully discussed by the local ethical committee and, as usually required by the majority of countries, by permission of the special legal courts. Living donor transplantation for commercial motivations must be strongly discouraged and is considered unacceptable by the majority of International Societies of Transplantation.