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Should people who donate a kidney to a stranger be permitted to choose their recipients? Views of the United States public.

BACKGROUND: Several transplant centers have begun to accept kidneys donated by altruistic living strangers. Many of these centers insist that such donations be nondirected, meaning that the donors may not choose their recipients. On the other hand, some authors have argued that anonymous donors should be allowed to select their recipients. This study was designed to explore public attitudes toward this issue. METHODS: Two telephone surveys of US adults, each including more than 1000 participants, were conducted. The first asked about the general acceptability of allowing altruistic strangers to direct donations, the willingness to donate a kidney to a stranger, and the impact of permitting directed donation on willingness to give. The second survey asked about the acceptability of directed donation to members of specific groups. RESULTS: About one quarter of the respondents said they would donate a kidney to a stranger for free, and the vast majority of them would donate even if they could not choose their recipients. Two thirds would not allow anonymous kidney donors to direct their gifts to a member of a specific racial or religious group, but three quarters would support kidney donations directed to children. CONCLUSIONS: These data support the current policy of several transplant centers that people who wish to donate a kidney to a stranger are not permitted to choose their recipients on the basis of membership in a racial or religious group. On the other hand, theoretical considerations and the results of this study suggest that people who wish to donate a kidney only to an unknown child should be permitted to do so.

Adult↗

Acquired immunodeficiency syndrome and directed blood donations. A dilemma for American medicine.

The devastating consequences of transfusion-associated acquired immunodeficiency syndrome have led some patients and physicians to propose recipient-orchestrated (directed) donations as a method of improving the safety of blood transfusions. This method is not safer than volunteer blood donation and introduces several legal, ethical, and administrative problems. Blood banks should discourage the use of directed blood donations, and physicians should work to educate the public about the lack of benefit of directed donations and their potential risks.

Acquired Immunodeficiency Syndrome↗

Non-genetic mothers and their own children: infertility and IVF donor birth.

Over the 1980s in Western societies which have used new reproductive technologies, there has been intense argumentation about connected philosophical, ethical and economic issues. This research on I.V.F. donor egg (i.e. 'non-genetic') motherhood is based on qualitative data from partial life histories of twelve women having children by this technology through a Melbourne infertility programme. Methodology, interpretation, and discussion place it within both critical social and feminist personal identity theoretical frameworks. None of the respondent women but all except one of their respective partners are the biological parents of a total of ten children already born at the data collection stage, and in three well-established pregnancies. Two-thirds of the respondents used 'unknown' donor ova. 'Known' donors were typically the recipients' sisters. Many of these Australian births represent world 'firsts' in medical technical applications. In biographical accounts, the focus was on experiences of social pressure towards parenthood, of infertility and medical treatment, and attitudes of openness or secrecy about using donated ova. While socially and technologically acquired parenthood added a highly-desired dimension to their social identities, a sense of loss appeared to persist in most of the women's personal identities. Where a policy of secrecy towards relatives and friends about use of reproductive technology and gamete donation was maintained, this loss was reinforced by a feeling of social isolation.

Australia↗

Fetal tissue research and the misread compromise.

The bill to restore federal funding for human fetal tissue research has been passed by the House and awaits Senate approval. But it requires women who are willing to donate fetal tissue to certify that they did not have an abortion with the intent to donate. It further requires researchers to keep the certifications on file and available for government audit. Both requirements spell trouble.

Aborted Fetus↗

Attitudinal survey of sperm donors to an artificial insemination clinic.

Donors (n = 42) to an artificial-insemination-by-donor sperm clinic were surveyed to ascertain individual motivations and attitudes regarding participation. Responses were compared to those of a matched control group (n = 50) of nondonors. Donors were motivated by money, with the majority (69%) unwilling to participate if financial incentives were withdrawn. Anonymity was desired, and donors did not favor disclosure of information to a national registry tracking insemination outcomes. However, donors and controls did endorse providing sperm for an infertile brother. Donors and controls differed significantly in response to 2 of 15 questions asked, with differences due to perceptions of donor motivation. Although perceived as altruistic by peers, donors did not envision themselves as such, and most considered donating semen similar to donating blood or organs.

Adult↗

Direction of the Organ Procurement and Transplantation Network and United Network for Organ Sharing regarding the oversight of live donor transplantation and solicitation for organs.

The Organ Procurement and Transplantation Network (OPTN) operated by United Network for Organ Sharing (UNOS) has taken recent steps to address public solicitation for organ donors and its oversight of live donor transplantation. This report provides the direction of the OPTN regarding deceased donor solicitation. The OPTN has authority under federal law to equitably allocate deceased donor organs within a single national network based upon medical criteria, not upon one's social or economic ability to utilize resources not available to all on the waiting list. The OPTN makes a distinction between solicitations for a live donor organ versus solicitations for directed donation of deceased organs. As to live donor solicitation, the OPTN cannot regulate or restrict ways relationships are developed in our society, nor does it seek to do so. OPTN members have a responsibility of helping protect potential recipients from hazards that can arise from public appeals for live donor organs. Oversight and support of the OPTN for live donor transplantation is now detailed by improving the reporting of live donor follow-up, by providing a mechanism for facilitating anonymous live kidney donation, and by providing information for potential live kidney donors via the UNOS Transplant Living website.

Directed Tissue Donation↗

[Reforming organ transplant law: a legal memorandum].

Two bills to reform 'Act Concerning Organ Transplantation' are going to the Diet. Both bills aim to enable to carry out'child organ transplantation'. The Japanese Act requires valid written consent of the donor to procure an organ from the dead body. A child under the age of fifteen is thought to be unable to express his or her valid will. This paper discusses various points implied in this issue: opt-in of donor, equality of human being prescribed in Constitution of Japan, the autonomy of the dead, preferred donation to a relative. Tissue transplantation and organ transplantation among the living, which are not included in the Act, are also discussed.

Adolescent↗