Should people who donate a kidney to a stranger be permitted to choose their recipients? Views of the United States public

Background. Several transplant centers have begun to accept kidneys donated by altruistic living strangers. Many of these centers insist that such donations be nondirected, meaning that the donors may not choose their recipients. On the other hand, some authors have argued that anonymous donors should be allowed to select their recipients. This study was designed to explore public attitudes toward this issue. Methods. Two telephone surveys of US adults, each including more than 1,000 participants, were conducted. The first asked about the general acceptability of allowing altruistic strangers to direct donations, the willingness to donate a kidney to a stranger, and the impact of permitting directed donation on willingness to give. The second survey asked about the acceptability of directed donation to members of specific groups. Results. About one quarter of the respondents said they would donate a kidney to a stranger for free, and the vast majority of them would donate even if they could not choose their recipients. Two thirds would not allow anonymous kidney donors to direct their gifts to a member of a specific racial or religious group, but three quarters would support kidney donations directed to children. Conclusions. These data support the current policy of several transplant centers that people who wish to donate a kidney to a stranger are not permitted to choose their recipients on the basis of membership in a racial or religious group. On the other hand, theoretical considerations and the results of this study suggest that people who wish to donate a kidney only to an unknown child should be permitted to do so.