Intended for healthcare professionals

Head To Head

Is it unethical for doctors to encourage healthy adults to donate a kidney to a stranger? Yes

BMJ 2011; 343 doi: (Published 15 November 2011) Cite this as: BMJ 2011;343:d7179
  1. Walter Glannon, associate professor of philosophy
  1. 1University of Calgary, Canada
  1. wglannon{at}

Walter Glannon argues that doctors should not encourage their patients to put themselves at risk for the benefit of others, but Antonia Cronin (doi:10.1136/bmj.d7140) believes that encouraging altruistic donation is legitimate

Although the number of kidneys transplanted from deceased and living donors has increased, the number of people with end stage renal disease needing a transplant exceeds the supply of these organs. One year graft survival is better for recipients of kidneys from living donors (96.8%) than for recipients of kidneys from deceased donors (92%).1 Only 4% of the first group experience delayed graft function compared with 24% of the second group.2 Given the need for kidneys and the superior outcomes of transplants from living versus deceased donors, there are compelling medical reasons for transplant organisations and medical professionals to promote living over deceased kidney donation.

The estimated risk of death from donating a kidney is 1 in 3000. The risk of perioperative and postoperative complications from unilateral laparoscopic nephrectomy is 10-15%.3 These include, but are not limited to, bleeding, infection, bowel injury, hernia, and postanaesthesia depression. The loss of renal mass from nephrectomy …

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