For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: (1) The living donor provides valid consent to donation. (2) Living donation produces an overall positive balance of harm–benefit for donors and recipients which cannot be obtained in a less harmful manner. (3) Donation is not liable to cause significant and long-term morbidity to, or the death of, the donor. This paper critically examines the suggestion that these criteria are not sufficient to offer a general account of justified living organ donation in the context of competent volunteers and that key to justified living organ donation is that donors receive sufficient benefits from their donation that these outweigh the harms they suffer. However, although this view—termed here ‘The Donor Benefit Standard’—directs welcome attention to the many and complex motives which may underlie living organ donation, this paper ultimately concludes that given the threats this position poses to individual autonomy and the lives of those in need of organ transplants ‘The Donor Benefit Standard’ should ultimately be rejected.
American Medical Association. 2016. AMA Code of Medical Ethics. Chicago: American Medical Association. https://www.ama-assn.org/sites/default/files/media-browser/principles-of-medical-ethics.pdf. Accessed 31 Jan 2017.
Barry, B. 1965. Political argument. London: Routledge.
Baylis, F. 2013. The ethics of creating children with three genetic parents. Reproductive Biomedicine Online 26 (6): 531–534. CrossRef
Brannstrom, M., Johannesson, L., Bokstrom, H., Kvarnstrom, N., Molne, J., Dahm-Kahler, P., Enskog, A., Milenkovic, M., Ekberg, J., Diaz-Garcia, C., Gabel, M., Hanafy, A., Hagberg, H., Olausson, M., and Nilsson, L. 2014. Livebirth after uterus transplantation. Lancet 385 (9968): 607–616. CrossRef
Canadian Medical Assocation. 2004. CMA Code of Ethics. Ottawa: Canadian Medical Association. https://www.cma.ca/Assets/assets-library/document/en/advocacy/policy-research/CMA_Policy_Code_of_ethics_of_the_Canadian_Medical_Association_Update_2004_PD04-06-e.pdf. Accessed 31 Jan 2017.
Challenor, J., and Watts, J. 2014. It seemed churlish not to’: How living non-directed kidney donors construct their altruism. Health 18 (4): 388–405. CrossRef
Cheyette, C. 2000. Organ harvests from the legally incompetent: An argument against compelled altruism. Boston College Law Review 41 (2): 465–515.
Christman, J. 2004. Relational autonomy, liberal individualism, and the social constitution of selves. Philosophical Studies 117 (1/2): 143–164. CrossRef
Clemens, K.K., Thiessen-Philbrook, H., Parikh, C.R., Karley, M. L., Boudville, N., Ramesh Prasad, G.V., and Garg, A.X. 2006. Psychosocial health of living kidney donors: A systematic review. American Journal of Transplantation 6 (12): 2965–2977. CrossRef
Curran, W.J. 1959. A problem of consent: Kidney transplantation in minors. New York University Law Review 34 (1): 891–898.
Den Hartogh, G. 2013. Is consent of the donor enough to justify the removal of living organs. Cambridge Quarterly of Healthcare Ethics 22 (1): 45–54. CrossRef
Dworkin, R. 1993. Life’s dominion: An argument about abortion, euthanasia and individual freedom. London: Harper Collins.
Elliott, C. 1995. Doing harm: Living organ donors, clinical research and the tenth man. Journal of Medical Ethics 21 (2): 91–96. CrossRef
Erim, Y., Beckmann, M., Valentin-Gamazo, C., Malago, M., Frilling, A., Schlaak, J.F., Gerken, G., Broelsch, C.E., and Senf, W. 2006. Quality of life and psychiatric complications after adult living donor liver transplantation. Liver Transplantation 12 (12): 1782–1790. CrossRef
Feenan, D. 1997. A good harvest? Re Y (mental incapacity. Bone marrow transplant. Child and Family Law Quarterly 9 (3): 305–312.
Feinberg, J. 1987. The moral limits of the criminal law Volume 1: Harm to others. Oxford: Oxford University Press. CrossRef
General Medical Council. 2013. Good Medical Practice. Manchester: General Medical Council. http://www.gmc-uk.org/static/documents/content/GMP_.pdf. Accessed 31 Jan 2017.
Glannon, W., and Ross, L.F. 2005. Response to “Intrafamilial organ donation is often an altruistic act” by Aaron Spital (CQ Vol 12, No 1) and “Donor Benefit is the key to justified living organ donation” by Aaron Spital (CQ Vol 13, No 1). Cambridge Quarterly of Healthcare Ethics 14 (2): 195–198. CrossRef
Harris, J. 1975. The survival lottery. Philosophy 50 (191): 81–87. CrossRef
Huxley, A. 1931. Do what you will. London: Chatto and Windus.
Jowsey, S.G., and Schneekloth, T.D. 2008. Psychosocial factors in living organ donation: clinical and ethical challenges. Transplantation Reviews 22 (3): 192–195. CrossRef
Levinsky, N. 1984. The doctor’s master. New England Journal of Medicine 311 (24): 1573–1575. CrossRef
Munson, N. 2002. Raising the dead: Organ transplants, ethics, and society. New York: Oxford University Press.
NHS Blood and Transplant. 2015. Organ donation and transplantation activity report 2014/15. London: NHS. http://nhsbtmediaservices.blob.core.windows.net/organ-donation-assets/pdfs/activity_report_2014_15.pdf. Accessed 31 Jan 2017.
Reese, P.P., Boudville, N., and Garg, A.X. 2015. Living kidney donation: outcomes, ethics, and uncertainty. Lancet 385 (9981): 2003–2013. CrossRef
Silber, S.J., Lenahan, K.M., Levine, D.J., Pineda, J.A., Gorman, K.S., Friez, M.J., Crawford, E.C., and Gosden, R.G. 2005. Ovarian Transplantation between monozygotic twins discordant for premature ovarian failure. The New England Journal of Medicine 353 (1): 58–63. CrossRef
Snyder, L. for the American College of Physicians Ethics, Professionalism, and Human Rights Committee. 2012. American College of physicians ethics manual: Sixth edition. Annals of Internal Medicine 156 (1): 73–104. CrossRef
Spital, A. 2004a. Donor benefit is the key to justified living organ donation. Cambridge Quarterly of Healthcare Ethics 13 (1): 105–109. CrossRef
Spital, A. 2004b. Rejecting heroic kidney donors protects much more than public trust. American Journal of Transplantation 4 (10): 1727. CrossRef
Spital, A. 2005a. Reply to Glannon and Ross: May parent to child organ donation be altrusitic? Cambridge Quarterly of Healthcare Ethics 14 (2): 195–198. CrossRef
Spital, A. 2005b. More on parental living liver donation for children with fulminant hepatic failure: Addressing concerns about competing interests, coercion, consent and balancing acts. American Journal of Transplantation 5 (11): 2619–2622. CrossRef
Spital, A. 2006. Living organ donation: Striking a proper balance and obtaining valid consent. Transplantation 82 (9): 1244–1245. CrossRef
Spital, A., and Jacobs, C.L. 2007. The beauty of the gift: The wonder of living organ donation. Clinical Transplantation 21 (4): 435–440. CrossRef
Spital, A., and Taylor, J.S. 2007. Living organ donation: Always ethically complex. Clinical Journal of the American Society Of Nephrology 2 (2): 203–204. CrossRef
Spital, A., and Taylor, J.S. 2008. Primum non nocere and living organ donation: A response to Dr. Klintmalm. American Journal of Transplantation 8 (6): 1352–1353. CrossRef
Starzl, T.E. 1967. Ethical problems in organ transplantation. Annals of Internal Medicine 67 (3): 32–36. CrossRef
Veatch, R.M. & L.F. Ross. 2015. Transplantation ethics. 2 edn. Washington DC: Georgetown University Press.
Webb, N.J.A., and Fortune, P.M. 2006. Should children ever be living kidney donors? Pediatric Transplantation 10 (7): 851–855. CrossRef
Weidebusch, S., Reiermann, S., Steinke, C., Muthny, F.A., Pavenstaedt, H.J., Schoene-Seifert, B., Senninger, N., Suwelack, B., and Buyx, A.M. 2009. Quality of life, coping, and mental health status after living kidney donation. Transplantation Proceedings 41 (5): 1483–1488. CrossRef
Wendler, D. 2010. Are physician’s obligated always to act in the patient’s best interests? Journal of Medical Ethics 36 (2): 66–70. CrossRef
Wilde, O. 1885. The Relation of Dress To Art. The Pall Mall Gazette. 28 Feb 1885.
Wilkinson, T.M. 2011. Ethics and the acquisition of organs. Oxford: Clarendon Press. CrossRef
World Health Organisation Global Knowledge Base on Transplantation. 2013. GKT1 Activity and Practices. Geneva: WHO. http://www.who.int/transplantation/gkt/statistics/en/. Accessed 31 Jan 2017.
World Medical Association. 2006. International Code of Medical Ethics. South Africa: World Medical Association. http://www.wma.net/en/30publications/10policies/c8/. Accessed 31 Jan 2017.
Hart v. Brown, 289 A.2d 386 (Conn. Super. Ct. 1972)
Masden v. Harrison,. Eq. No. 68651 (Mass. 1957)
Re Y (Mental Incapacity) 2 FLR 787
Strunk v. Strunk, 445 S.W.2d 145 (Ct. of Appeals, Ky. 1969)
- On harm thresholds and living organ donation: must the living donor benefit, on balance, from his donation?
Nicola Jane Williams
- Springer Netherlands
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
e.Med Kampagnen-Visual, Mail Icon II