Is altruistic-directed living unrelated organ donation a legal fiction?

Miran Epstein and Gabriel Danovitch


The majority of pertinent political and professional bodies now regard ‘altruism’ and ‘solidarity’ as the sole foundations of any acceptable donor–recipient interaction. The European Directive, for example, makes an unequivocal statement in this respect.

“As a matter of principle, tissue and cell application programmes should be founded on the philosophy of voluntary and unpaid donation, anonymity of both donor and recipient, altruism of the donor and solidarity between donor and recipient. [1]”

Similar views have equally been endorsed inter alia by American law, the World Health Organization (WHO), and, most recently, The Transplantation Society (TTS) [2–4]. Whatever the dictionary definition of ‘altruism’ and ‘solidarity’, in the legal transplant jargon they have come to be understood as any motivation for organ donation other than such that are formed under consent-invalidating coercion. In fact, unless otherwise specified, the term ‘altruistic donation’ has come to mean ‘non-commercial donation’.

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