Am I My Brother's Keeper? The Role of the Blameless Medical Excuse in Living Donor Organ Transplantation

12 Pages Posted: 18 Apr 2006

See all articles by Peter Angelos

Peter Angelos

Northwestern University

Mary Simmerling

Adler University; Cornell University, Weill Cornell Medical College

Joel Frader

Northwestern University - Feinberg School of Medicine

John Franklin

Northwestern University - Feinberg School of Medicine

Joe Leventhal

Northwestern University - Feinberg School of Medicine

Michael Abecassis

Northwestern University - Feinberg School of Medicine

Abstract

Most living donors come from the same family or social unit with emotional or biologic ties to the intended recipient. Their motivation to donate may include a sense of duty, obligation, or love for the intended recipient and may be exaggerated by the plight of a deteriorating ill relative or friend. These factors and relationships could affect the extent to which potential donors feel free to express a desire not to donate. Organ transplant centers have employed the medical excuse as a way to provide a seemingly blame-free reason potential donors can use to opt-out of the donation process. Although originally intended as an immediate shield from pressures to donate, transplant teams now invoke the medical excuse in a variety of situations. The medical excuse is used routinely by transplant programs, nationally and internationally to help potential donors who are either hesitant or unwilling to proceed with living donation. However, the ethical issues engendered by the blameless excuse have received little critical attention. The objectives of this report are 1) to define the blameless excuse and illustrate its use in a series of cases, and 2) to highlight some of the ethical issues that arise from its use. We propose that the routine use of the blameless excuse has ramifications that are poorly characterized and that deserve further empirical and analytic attention. We propose further that the transplant community should consider abandoning the routine use of the medical excuse in the context of living donor transplantation.

Keywords: Living organ donor, transplantation, ethics, medical excuse, lying

JEL Classification: I18

Suggested Citation

Angelos, Peter and Simmerling, Mary and Frader, Joel and Franklin, John and Leventhal, Joe and Abecassis, Michael, Am I My Brother's Keeper? The Role of the Blameless Medical Excuse in Living Donor Organ Transplantation. Available at SSRN: https://ssrn.com/abstract=896242

Peter Angelos

Northwestern University ( email )

2001 Sheridan Road
Evanston, IL 60208
United States

Mary Simmerling (Contact Author)

Adler University ( email )

17 N. Dearborn
Chicago, IL 60604
United States

Cornell University, Weill Cornell Medical College ( email )

1300 York Avenue
New York, NY 10065
United States

HOME PAGE: http://https://vivo.weill.cornell.edu/display/cwid-mcs2006

Joel Frader

Northwestern University - Feinberg School of Medicine ( email )

Chicago, IL 60611
United States

John Franklin

Northwestern University - Feinberg School of Medicine ( email )

Chicago, IL 60611
United States

Joe Leventhal

Northwestern University - Feinberg School of Medicine ( email )

Chicago, IL 60611
United States

Michael Abecassis

Northwestern University - Feinberg School of Medicine ( email )

Chicago, IL 60611
United States

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