Hilhorst Medard T
University Medical Centre (Room EE 2055), Faculty of Medicine and Health Care, Department of Medical Ethics and Philosophy, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
Ethical Theory Moral Pract. 2005 Apr;8(1-2):197-215. doi: 10.1007/s10677-005-3295-3.
Arguments against directed altruistic living organ donations are too weak to justify a ban. Potential donors who want to specify the non-related person or group of persons to receive their donated kidney should be accepted. The arguments against, based on considerations of motivation, fairness and (non-)anonymity (e.g. those recently cited by an advisory report of the Dutch Health Council), are presented and discussed, as well as the Dutch Government's response. Whereas the Government argues that individuals have authority with regard to the allocation of their organs, partial considerations have not been sufficiently explored. In addition, it is argued that partial relationships govern human life, are significant and should be valued highly. These relationships are at the core of accepted living kidney donation between relatives (family members, partners, friends). Respecting the particular act of living donation goes beyond respect for autonomy; it touches upon our personal and social identity. Donation, e.g. of a kidney, is not undertaken strictly for the benefit of the recipient, but also to meet the moral standards we wish to set for ourselves. This consideration, rooted in a view of moral identity, provides the basis for many forms of directed donation that are both partial and justified. If the importance of this is not recognized, social policies can be neither adequate nor effective.
反对定向利他性活体器官捐赠的理由太过薄弱，不足以成为禁令的依据。应该接受那些希望指定非亲属个人或群体来接受其捐赠肾脏的潜在捐赠者。本文将呈现并讨论基于动机、公平性和（非）匿名性考量（例如荷兰卫生委员会一份咨询报告近期所引用的那些理由）的反对观点，以及荷兰政府的回应。尽管政府认为个人对其器官分配拥有自主权，但尚未充分探讨一些片面的考量因素。此外，有人认为片面关系支配着人类生活，意义重大且应得到高度重视。这些关系是亲属（家庭成员、伴侣、朋友）间可接受的活体肾脏捐赠的核心所在。尊重活体捐赠这一特定行为，超越了对自主权的尊重；它触及到我们的个人和社会身份认同。捐赠，比如捐赠肾脏，并非仅仅是为了受赠者的利益，也是为了符合我们希望为自己设定的道德标准。这种基于道德身份认同观点的考量，为许多既片面又合理的定向捐赠形式提供了基础。如果不认识到这一点的重要性，社会政策就既不充分也无实效。
