The Role of Body Concepts for Donation Willingness. Insights from a Survey with German Medical and Economics Students

An ethical comparison of living kidney donation and surrogacy: understanding the relational dimension

“…Parent-child relationships, for example, tend to become more intimate [18, 19], whereas sibling pairs or married couples are more likely to face conflicts in their relationships, for example due to controlling or autonomy-restricting behavior [26]. Amongst siblings, for example, a simple greeting gesture, where the donor asks the recipient “how are you?” has been shown to be interpreted by the recipient as a kind of control, whether he lives a health-conscious life with the donated kidney [27]. In general, there is evidence that the bodily exchange of organs leads to an intensification of preexisting relational dynamics amongst family members – for better or worse [17, 28].…”

“…In a similar vein, LKD is predominantly depicted as a positive action in public and medial representations. Thereby the donated organ is increasingly perceived as something that is endowed to one’s next of kin in a medical emergency or even something one should give [27]. In the context of intra-familial donation, notions of mutual obligation take on a specific shape against the background of established roles within the family [51].…”

“…In fact, studies focusing on parents who donated an organ to their children reveal that not all potential familial options for donation were discussed within the family insofar as mothers often regard themselves as the only option for securing the survival of their child [17, 26]. Especially women with a traditional understanding of gender roles regard LKD as an expansion of their familial obligations [27, 29]. This is not least reflected by the fact, that two-thirds of the kidneys donated every year stem from women [52].…”

“…As it has been shown, women tend to allude to holistic body concepts. In particular, they stress the reproductive capacity of their bodies by drawing direct comparisons between birth, motherhood and the mother-child relationship [27]. In this regard, the familiar image of the self-sacrificing mother functions as a cultural mechanism that enables the transplant endeavor [55].…”

“…The fact that mothers can benefit from donation themselves, for example, by experiencing high social recognition and prestige within their social setting, displays another argument challenging the notion of exploitation [56]. As regards the autonomy of mothers but also other family members, the latter’s decision to donate an organ is often framed as a matter of relational autonomy [27, 57]. As it has been noted “to be autonomous, in a relational sense, is to be responsive and responsible to others, and interdependent within complex networks of relationships, which will not always easily accord with the practices and expectations we have normalized in cultures that have elevated ‘the individual’” [58].…”