Donor's Choice or Hobson's Choice?

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Abstract
• During the evaluation of the living-related renal donor, medical abnormalities may be uncovered. When the added risk to the donor, resulting from such abnormalities, is greater than the chance of a successful transplant, most would agree that such individuals should be excluded from donating. However, when minor abnormalities are uncovered, adding small or unknown risk, is the donor given a choice in his own medical suitability? To answer this, a questionnaire was mailed to transplant centers around the country. The results indicate that many centers do not allow the potential donor to accept uncertain risks. In their effort to protect the donor, these centers actually practice pseudoprotectionism, since they deprive some individuals of the right to give, perhaps one of life's most meaningful experiences. We propose that under the circumstances described, the final decision regarding acceptability for donation should rest with the donor. If this attitude were adopted, perhaps the renal donor pool would increase. (Arch Intern Med1985;145:1297-1301)

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