Are “Stranger Donors” Irrational?

This chapter seeks to understand the motivations of people who offered to donate a kidney to a stranger. It explores the degree of emotional relationship that was essential to justify the claim that donation provided a psychological benefit to the donor. The chapter also mentions a law in the United Kingdom called the Unrelated Live Transplant Registry Authority which required organ donors to provide proof that they had a relationship with the recipient. In the United States, however, there is no federal legislation or public policy regulating stranger donors. The chapter then turns to discuss a study led by nephrologist Aaron Spital showing how attitudes within the transplant community gradually shifted from almost universal rejection of stranger donors to their gradual acceptance. It assesses the struggles that nephrologists went through in trying to determine whether such altruists were noble or irrational. Ultimately, the chapter offers a unique glimpse into the motivations of an altruistic donor and into the forms of skepticism that doctors and psychologists bring to evaluations of such donors.