Self-determination in Living Organ Donation: an Empirically Informed Contribution to Ethical Issues in Decision Making

Abstract

Living organ donation has become a routinized procedure in transplantation medicine in Germany. Despite the existence of a normative-legal framework ethical questions concerning self-determined decisions remain unanswered. This article, based on a qualitative socio-empirical study, addresses how family decisions are made concerning living organ donation and to which extent internal and external constraints affecting the voluntary nature of this decision are found among the interviewed people. The analysis revealed that the central decision for living organ donation was made in the context of the family. The decision was thereby decisively encouraged by the donors, the recipients, on the other hand, were rather passive in the decision-making process. Especially among the organ recipients no purely autonomous decision took place. The empirical results, which will be presented in a first step, provide the framework for the medical ethical recommendations regarding living organ donation in Germany developed in a second step.