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Live Organ Donation: Social Context, Clinical Encounter, and the Psychology of Communication

Received May 5, 2004; revision received Aug. 9, 2004; accepted Sept. 14, 2004. From the Departments of Psychiatry and the liver transplant services of Massachusetts General Hospital and University of Tokyo Medical Center; and the Department of Communications Psychology, California State University, Long Beach. Address correspondence and reprint requests to Dr. Surman, Department of Psychiatry, Massachusetts General Hospital, WANG ACC-812, 15 Parkman St., Boston, MA 02114; osurman{at}partners.org (e-mail).

Organ transplantation is increasingly available to the thousands of patients who suffer from end-organ failure. There has been an attendant increase in demand for living donor participation. This combined with a bioethical focus on autonomy increases the burden of decision on donor candidates. The authors review the history of living donor participation in organ transplantation and explore the psychological dynamics of the clinical encounter between donor and transplant surgeon. The field of communication psychology lends to the understanding of coercion and to the importance of donors possessing a status of patient-hood in the classical Hippocratic condition.

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