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A Proposed Ethical Framework for the Psychosocial Evaluation of the Living Kidney Donor

Lim, Crystal (2015) A Proposed Ethical Framework for the Psychosocial Evaluation of the Living Kidney Donor. Master's Thesis, University of Pittsburgh. (Unpublished)

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This thesis argues that living kidney donation (LKD) is ethically justified, despite the donor’s exposure to its inherent risks and harm, because permitting justified cases of LKD upholds the autonomous decision of the donor to pursue his/her life values and direction. Consideration of the psychological and emotional benefits of LKD and the harm from being prevented to donate allows a more comprehensive perspective of LKD. Medical and psychosocial evaluations of prospective donors function as procedural safeguards. These evaluations aim to protect the well-being of donors by minimizing the risks to the donor, while recognizing the donor’s interest in donation and rights of autonomous decision making. Evaluations also reveal pertinent information to transplant professionals to help them weigh the risks and benefits of LKD specific to individual prospective donors. For the LKD to move forward, a prospective donor must meet established medical and psychosocial criteria.
In Singapore, the Human Organ Transplant Act (HOTA) charges a medical social worker with performing the psychosocial evaluation of the prospective donor, and this evaluation is regarded as the expert review which a nationally-appointed transplant ethics committee relies upon in authorizing applications for living kidney donations and transplants. The thesis presents assessment domains for this psychosocial evaluation of the donor, connects these domains to normative principles purporting to justify their inclusion, and highlights those domains that may raise ethical challenges. The thesis discusses the psychosocial evaluation process as currently undertaken in Singapore, and how the inclusion of a collateral person, as contemplated by the HOTA, can be ethically problematic. While social workers are well-suited to conduct the psychosocial assessment because of their training, experience and the normative commitments of their profession, their involvement also raises some ethical concerns that are discussed.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairParker, Lisalisap@pitt.eduLISAP
Committee MemberWicclair, Markwicclair@pitt.eduWICCLAIR
Committee MemberSatkoske,
Date: 9 September 2015
Date Type: Publication
Defense Date: 16 July 2015
Approval Date: 9 September 2015
Submission Date: 11 August 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 75
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Bioethics
Degree: MA - Master of Arts
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Psychosocial evaluation, living kidney donation, ethical framework, donor psychosocial evaluation
Date Deposited: 09 Sep 2015 12:39
Last Modified: 15 Nov 2016 14:29


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