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It may be that we should question this policy for cadaveric organs as well, but I will limit my comments to living donors. I would like to thank Carol Stocking, Ph.D., for pushing me on this issue and Glannon, Walter, Ph.D., for helping me to critically examine the ethics raised by this issue.Google Scholar

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I write that the obstacle was or should have been understood to be physiologic and not moral, because this was not the case at all transplant centers. Elsewhere, my colleagues and I explore the basis for this policy, which was twofold. First was the belief that the improved transplant survival that was seen with living donors was due to a degree of genetic similarity between the donor and recipient (i.e., matching for minor as well as major histocompatibility antigens) that was not possible with unrelated donors. This was found to be less important than the fact that the organ was from a living person. Second, many transplant programs were also of the belief that only biological family members were properly motivated. The exclusion of all nongenetic relatives failed to distinguish between the emotionally related nongenetic relative (e.g., spouse or close personal friend) and the non-emotionally related stranger, and “suggests a misguided valuation of genetic relationships instead of on relationships grounded in intimacy.”Google Scholar

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