The ethics of unconventional living organ donation

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Abstract
The ongoing organ shortage is perhaps the major barrier facing transplantation today. Liberalizing selection criteria for living donors to include such unconventional sources as unrelated individuals and relatives at added risk could greatly increase the pool of available organs. Yet, transplant centers, appropriately concerned about the donor's motivation and the risk involved, have generally excluded these people from donation. Does this policy make sense? Assuming the donor to be competent, I will show that if traditional genetically related donors are believed to be ethically acceptable, it is inconsistent to exclude emotionally related donors. I will also argue that even the use of altruistic strangers and donors at added risk is ethically justified. These conclusions are based on the principle of respect for persons and the realization that the risk‐benefit ratio of any proposed living donor transplant is determined ultimately by value judgments. These judgments should generally be made by the one most affected by the outcome – the prospective donor.

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