Am I My Brother's Keeper? The Role of the Blameless Medical Excuse in Living Donor Organ Transplantation
12 Pages Posted: 18 Apr 2006
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: Suggested Citation