Ethical Issues Regarding Donors’ Voluntariness in Living Renal Transplantation

Umi Miura
Volume 5 Issue 1 Pages 73-81
First Published: August 9, 2022
[in Japanese]



The Ethical Guidelines of the Japan Society for Transplantation state that, in principle, donors for living renal transplantation should be limited to relatives of recipients. It has been pointed out that this may create “pressure” on relatives to become donors, which may undermine the donor’s voluntariness.Hotta (2006) pointed out that the reason for this “pressure” is that the causal pathway between the relative’s decision to be a donor or not and the recipient’s state of recovery or not is made visible. Moreover, he proposed a system to reduce the “pressure” by making the causal pathway invisible.However, his argument needs to be modified. In addition, if the system proposed by him is introduced to living renal transplantation, it is expected that the “pressure” will be reduced, but the situation will not be acceptable to society.
On the other hand, the system proposed by Hotta (2006) works ideally in blood donation. In order for this system to function ideally in living renal transplantation as it does in blood donation, a large number of potential donors would be needed to satisfy the recipient’s them.


Key words

 living renal transplantation, voluntariness, organ trade, blood donation