Self-interest, self-abnegation and self-esteem: towards a new moral economy of non-directed kidney donation.

As of September 2006, non-directed donation of kidneys and other tissues and organs is permitted in the UK under the new Human Tissue Acts. At the same time as making provision for psychiatric and clinical assessment of so-called "altruistic" donations to complete strangers, the Acts intensify assessments required for familial, genetically related donations, which will now require the same level as genetically unrelated but "emotionally" connected donations by locally based independent assessors reporting to the newly constituted Human Tissue Authority. But there will also need to be considerable reflection on the criteria for "stranger donation", which may lead us to a new understanding of the moral economy of altruistic organ donation, no matter how mixed the motives of the donor may be. This paper looks at some of the issues that will have to be accommodated in such a framework.