Altruism in Disrepute: Medical versus Public Attitudes toward the Living Organ Donor

There is much evidence that the medical profession looks upon the motivation of the living organ donor with distrust and suspicion. If he is genetically related to the recipient, it is the family who is suspected of exerting undue pressure. If he is unrelated and not connected to the recipient by any emotional ties, he is suspected of being mentally ill or emotionally unbalanced, and almost all transplant centers will exclude him a priori from donation. By contrast, a substantial proportion of the public, especially among the young and well educated, consider the use of the living organ donor — even for saving strangers — to be a reasonable procedure and one for which they themselves might volunteer. The living organ donor presents an entirely new phenomenon in medicine. He may have only a transitional role and may disappear with improving immunosuppressive technics and better utilization and preservation of cadaver organs. Of course, we shall be happy to see him go, but for the time being he is still with us and raises some very important behavioral and ethical problems. In previous papers¹,² we have offered some comments on the living kidney donor, his decision-making process, the role of the family in donor selection, the problem of informed consent, and the impact of donorship on the subject's self-concept.