Abstract: This article discusses a series of ethical and religious elements that occur in the debate concerning altruistic living unrelated organ donation. Our main focus is on the ethical attitude of altruist donation. In order to illustrate the connections between ethics and religion we use as a case study the group of the so-called "Jesus Christians". It is evident that this group, as a case study, is more important for the ethical and religious issues than for the medical issues related to organ donation and transplantation. However, it suggests the potential that, in certain cultural contexts, ethics and religion may have in promoting the idea of altruist donation.
Key Words: ethics, religion, medical ethics, living unrelated donation, the Jesus Christian donors, altruistic donation, organ commercialization
Religious beliefs, medical ethics and altruistic organ donation
Living unrelated donation out of purely altruist reasons is a phenomenon that has started to develop especially in the US and the Northern European countries. US statistics for the recent years show a slow, but encouraging increase in numbers of organs transplanted in altruist donor-oriented programs. Actually, if compared both with deceased donation and living related donation, living unrelated donation (LURD) is the only category that steadily increased after 1990.1
Initially, this category of donors was encountered by the medical body with suspicion and examination of a supposed psychopathology. Since their consideration as medical subjects, living donors have raised the attention of practitioners as a peculiar category that, in the absence of an explicit therapeutic benefit, was assimilated to the category of healthy volunteers involved in clinical experimentation2. In this respect, the medical response was similar to the legislative reluctance towards this category of donors discussed in the section below. However, psychological studies conducted on unrelated living donors concluded that:
"all of these remarkable people felt good about having donated and none experienced psychological complications or regrets after donating. More than half the donors actually thanked the health care team for having given them the opportunity to donate and offered to speak about their experiences to help promote organ donation."3
Nevertheless, the psychological studies described above are usually limited in that they cover very small numbers of donors, and cannot be generalized in order to predict the behavior of larger social categories.4 Thus, although physical altruist donors can be described in psychological terms, defining what "altruist donation" is in general and conceptual terms may prove to be rather difficult. Usually, an act is called altruistic provided that it is done out of pure disinterest, for the sole benefit of the recipient, and without looking for anything in return. In this respect it exceeds the sphere of acts from duty, entering the sphere of superogatory acts (those acts that are highly praised and respected, without a possibility of being prescribed - such as the acts of charity). Elsewhere we mentioned about the puzzlement the double fold "altruistic" unrelated donors have created (giving the fact that organ donation, regardless of the type, must be altruistic in order to be legal in most countries).5 To this, another paradox is added: ethically speaking, altruist acts are highly praiseworthy, but simultaneously singular and imprescriptible en masse. If one wishes to encourage this type of actions, one may recommend it by promoting it through a visible model, and hope that the others will follow it.6
This is the context in which in this paper we would like to discuss the case of a small (but by no means unimportant) religious group, self-called "the Jesus Christians"7. Undoubtly, they cannot be taken as a model that could solve, even partially, the problem of LURD. However, they represent a particular case of the interaction between ethics and religion in the context of an objective lack of solutions in the case of a serious medical issue, namely transplantation and the insufficient donors' number. …