Will you give my kidney back? Organ restitution in living-related kidney transplantation: ethical analyses

Published on Sep 19, 2019in Journal of Medical Ethics2.19
· DOI :10.1136/medethics-2019-105507
Eisuke Nakazawa3
Estimated H-index: 3
(UTokyo: University of Tokyo),
Keiichiro Yamamoto1
Estimated H-index: 1
(UTokyo: University of Tokyo)
+ 3 AuthorsAkira Akabayashi20
Estimated H-index: 20
In this article, we perform a thought experiment about living donor kidney transplantation. If a living kidney donor becomes in need of renal replacement treatment due to dysfunction of the remaining kidney after donation, can the donor ask the recipient to give back the kidney that had been donated? We call this problem organ restitution and discussed it from the ethical viewpoint. Living organ transplantation is a kind of ‘designated donation’ and subsequently has a contract-like character. First, assuming a case in which original donor (A) wishes the return of the organ which had been transplanted into B, and the original recipient (B) agrees, organ restitution will be permissible based on contract-like agreement. However, careful and detailed consideration is necessary to determine whether this leaves no room to question the authenticity of B’s consent. Second, if B offers to give back the organ to A, then B’s act is a supererogatory act, and is praiseworthy and meritorious. Such an offer is a matter of virtue, not obligation. Third, if A wishes B to return the organ, but B does not wish/allow this to happen, it is likely difficult to justify returning the organ to A by violating B’s right to bodily integrity. But B’s refusal to return the donated organ cannot be deemed praiseworthy, because B forgets the great kindness once received from A. Rather than calling this an obligation, we encourage B to consider such virtuous conduct.
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#1Eisuke Nakazawa (UTokyo: University of Tokyo)H-Index: 3
#2Shoichi Maeda (Keio: Keio University)H-Index: 5
Last.Akira Akabayashi (NYU: New York University)H-Index: 1
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#1Serkan Yildiz (Dokuz Eylül University)H-Index: 5
#2Ali Celik (Dokuz Eylül University)H-Index: 13
Last.Taner Camsari (Dokuz Eylül University)H-Index: 17
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#1Sung Jae Park (Inje University)H-Index: 3
#2Sang Hoon Oh (Inje University)H-Index: 2
Last.Y. Kim (Inje University)H-Index: 5
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#1Pradeep V. Kadambi (UTMB: University of Texas Medical Branch)H-Index: 10
#2W. James Chon (U of C: University of Chicago)H-Index: 8
Last.Marc R. Garfinkel (SIU: Southern Illinois University Carbondale)H-Index: 14
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