Altruism or solidarity? The motives for organ donation and two proposals

Bioethics

Volumn 26, Issue 7, 2012, Pages 376-381

  Saunders, Ben ^a  

^a UNIVERSITY OF STIRLING   (United Kingdom)

Author keywords

Altruism; Directed donation; Incentives; Organ donation; Organ procurement; Solidarity

Indexed keywords

ALTRUISM; ARTICLE; COOPERATION; DIRECTED TISSUE DONATION; ETHICS; HUMAN; MOTIVATION; SOCIAL SUPPORT; TRANSPLANTATION;

ALTRUISM; COOPERATIVE BEHAVIOR; DIRECTED TISSUE DONATION; HUMANS; MOTIVATION; SOCIAL SUPPORT; TISSUE AND ORGAN PROCUREMENT;

EID: 84865385286     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2012.01989.x     Document Type: Article

References (31)

1. R. Titmuss. 1970. The Gift Relationship: From Human Blood to Social Policy. London: Allen and Unwin; P. Singer. Altruism and Commerce: A Defense of Titmuss against Arrow. Philos Public Aff 1973; 2: &(though Titmuss is specifically concerned with blood, rather than organs). As I was putting the finishing touches to this paper, controversy erupted over the issue of payments in the UK due to S. Rabbitt Roff, 'We Should Consider Paying Kidney Donors', Br Med J 2011; 343: d4867 [doi:10.1136/bmj.d4867]. See the quoted remarks of Dr Tony Calland quoted by the British Broadcasting Corporation (BBC). 2011. Kidney Donors Payments 'Would Save Lives'. London: BBC. Available at: [accessed 3 Aug 2011]. http://www.bbc.co.uk/news/uk-scotland-tayside-central-14379215
2. For a variety of perspectives on altruism, see the papers collected in J. Mansbridge, ed. 1990. Beyond Self-Interest. Chicago: University of Chicago Press
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26. And these ways need not be financial. One might 'contribute' by living a healthy lifestyle that puts less strain on the health service. If such a person needs a liver transplant, it would seem unfair to give priority to an alcoholic, whose liver disease was self-inflicted, simply because the latter was a registered donor.
27. Though perhaps not much more complicated. Maybe all that is necessary is that others be willing to cooperate, whether or not they can.
28. I would suggest that we allow donors to specify a priority, but not to restrict their organs absolutely. Thus, one may insist that one's organ will go to a white person in preference to any black people, but not that it could never go to a black person, if there were no whites on the waiting list. But this is a matter of practical implementation, rather than policy.
29. J. Rawls. 1999. A Theory of Justice. Revised edition. Oxford: Oxford University Press: 53.
30. Though age might figure in determining priority for transplants. Moreover it might be worried that some other criteria, such as compatibility, might amount to indirect discrimination. I bracket such concerns here.
31. Moreover, it should be remembered that if one organ has a 'whites only' directive, giving that organ to a white recipient may free up the undirected organ that they would have received for a black person. We may even adjust existing allocation criteria to minimize the effects of discrimination. For instance, if the top of our waiting list has 1) white