Clinical Ethics Council, Geneva University Hospitals, Geneva, Switzerland.
Pain and Palliative Care Consultation, Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, Geneva, Switzerland.
J Med Ethics. 2017 Nov;43(11):762-765. doi: 10.1136/medethics-2016-103698. Epub 2017 Mar 29.
Gratitude is both expected and problematic in live organ donation. Are there grounds to require it, and to forbid access to live donor transplantation to a recipient who fails to signal that he feels any form of gratitude? Recipient gratitude is not currently required for organ donation, but it is expected and may be a moral requirement. Despite this, we argue that making it a condition for live organ transplantation would be unjustified. It would constitute a problematic and disproportionate punishment for perceived immoral behaviour on the part of the recipient. It would also bar the donor from positive aspects of organ donation that remain even in the absence of recipient gratitude. A potential recipient's lack of gratitude should be explored as a possible symptom of other morally problematic issues and integrated into the information provided to the potential donor. Recognition of the donor's gift and gratitude for it may also need to be expressed in part by others. This last aspect is relevant even in cases where the recipient feels and expresses gratitude.
感激之情在活体器官捐献中既被期待又存在问题。是否有理由要求接受者表示感激，并禁止未能表现出任何形式感激之情的接受者接受活体捐献者的移植？目前，器官捐赠并不要求接受者表示感激，但人们期望接受者表示感激，并且感激可能是一种道德要求。尽管如此，我们认为将其作为活体器官移植的条件是不合理的。这将构成对接受者被认为不道德行为的有问题和不成比例的惩罚。这也将使捐献者无法获得即使在没有接受者感激的情况下仍然存在的器官捐献的积极方面。应该将潜在接受者缺乏感激之情视为其他道德问题的可能症状，并将其纳入向潜在捐献者提供的信息中。对捐献者的礼物的认可和感激也可能需要由其他人来表达。即使接受者感到并表达了感激之情，最后这一方面也是相关的。
