Beyond the Altruistic Donor: Embedding Solidarity in Organ Procurement Policies

Abstract

Altruism and solidarity are concepts that are closely related to organ donation for transplantation. On the one hand, they are typically used for encouraging people to donate. On the other hand, they also underpin the regulations in force in each country to different extents. They are often used indistinctly and equivocally, despite the different ethical implications of each concept. This paper aims to clarify to what extent we can speak of altruism and solidarity in the predominant models of organ donation. It also raises the ethical question of whether these categories are adequate as a basis for such models, bearing in mind that organs are a scarce resource and that a shortage of them may mean that fewer lives are saved or improved.

Mapping trust relationships in organ donation and transplantation: a conceptual model

“…The ethical justification for organ procurement, both living and cadaveric, is generally considered to rest on the principle of autonomy, i.e., the donor’s own consent 5 and/or the authorisation of family members [ 4 ]. On the one hand, potential donors need to trust that their relatives will respect their wishes after death [ 49 ].…”

“…This wish may be based on the comforting idea that helping others gives meaning to death, or on a sense of duty or moral obligation to others that is required of every member of society, or on the idea that there is indeed reciprocity in that we as a society benefit from having an effective ODT system. Therefore, although organ donation is usually seen as the epitome of altruism, it may also (or instead) be based on solidarity [ 4 ].…”