Benefits of Live Donation

A heart-warming story about an 'altruistic' (or live) kidney donor receiving a letter of thanks from the family she helped here. It's good to see donation get regular good press, rather than only being covered when there are scandals.

For the record, the scare quotes round 'altruistic' in the first sentence are not intended to question Ms Pretty's obvious altruism; rather, I find it odd that live donors who donate to strangers (rather than relatives) are referred to as 'altruistic donors', given the commonplace belief that all donations should be altruistic - a reasoning which is often appealed to in order to resist incentives for donors.

If you're interested in this issue, there's a nice piece by Greg Moorlock discussing the altruism requirement in the Journal of Medical Ethics (open access). The next meeting of the RSE project, on Saturday 14th September, will focus on incentives and inducements, so look out for further posts on that theme.

Altruistic Donation

The UK's first altruistic liver transplant (that is, one from a live donor to a stranger) was performed last month. The unusual thing about the liver is that one can donate a liver lobe and then one's liver can re-grow so, unlike donating a kidney, one may be no worse off in the long term. In the short term, however, the donor may suffer as a result of the operation, which in this case took four hours and left a 6" scar, as well as the risk of infection and/or psychological problems. This pieces also highlights the risk of death: approximately 0.5%.

Given these costs, it's unsurprising that Dr Aluvihare - transplant specialist at King's College Hospital - is quoted as saying "I personally have some reservations about altruistic donations. I believe if we did everything we can to improve the supply of donations after death we wouldn't have a need for this type of donation". So the case for favouring posthumous donation isn't simply that people's organs are of little use to them after they die, but also that the costs of removing those organs are much lower.

The Gift of Life

I didn't see this is the national news, so it's fortunate that I happened to be visiting relatives, since it was on the front page of the local newspaper on Christmas Eve. A 62 year old woman, Sue Dawson, donated a kidney to an anonymous recipient. It's good to see positive coverage of such acts, to reinforce the message that organ donation can do a lot of good.

That said, I think live donation, at least to a stranger (as here), is more than ought to be expected from anyone. It's what philosophers call supererogatory, which means basically beyond the call of duty. Those like Mrs Dawson who want to do this should rightly be praised for their generosity and the good that they do, but others shouldn't feel bad about not volunteering their live organs.

The issue of posthumous (after death) donation, however, is different. Morally speaking, I'm inclined to think that most people act wrongly by refusing to donate posthumous organs.