Should Society Encourage Living Donation?

The Tension Between Encouragement and Pressure

A common concern is that promoting living donation could pressure vulnerable people into a decision they might regret. This is a serious ethical consideration. No one should feel obligated to donate. Informed consent must be voluntary, and potential donors must have the right to withdraw at any stage without judgment.

Yet encouragement and pressure are not the same. Encouragement means providing accurate information, reducing stigma, and making it easier for willing donors to come forward. Pressure implies coercion, manipulation, or undue influence. Well-designed systems can do the former without the latter.

The Role of Regulation

Strong regulation protects donors. Mandatory independent assessments, ethics committees, and donor advocates exist precisely to ensure that donation is voluntary and informed. The goal is not to discourage altruism, but to channel it safely. Countries with robust oversight—such as the UK, Canada, and parts of the US—have seen growth in living donation without evidence of increased coercion.

The alternative—silence and stigma—may feel safer, but it leaves potential donors uninformed and potential recipients without options. Transparency and education, within a protective framework, serve both.

Altruism as Social Good

Voluntary altruism is a legitimate and powerful force. Societies that recognize this—and create structures to support it—can reduce suffering without compromising donor welfare. Encouraging donation, done right, is not exploitation. It is respect for the human capacity to give.