Background: Living donor transplantation confers a
better outcome for the recipient and is the preferred form
of kidney transplantation by most patients due to lack of
cadaver donors, poor access to cadaver program or less
favored by recipients due to poor outcome and increase
hospitalization cost. Several motives for kidney donation
have been identified in earlier studies such as altruism,
moral duty, religious beliefs, external pressures, guilt
from past relationships, self benefit, improved self
esteem, and identification with the recipient. Kidney
transplantation in a developing country such as ours,
with the commercialization of health services, where
agents and vendors earn their livelihood thru organ
selling made organ donation vulnerable to abuse. with our
moral obligation at hand, a necessity to understand the
psychological and social factors donors considers prior
to facing kidney donation.
Methods: The purpose of this research is to
describe experiences and feelings of donors of nonrelated
kidney transplantation at St. Luke’s Medical
Center to understanding the essence of non-related living
donation in our setting. The conduct of interview by the
psychiatrist was performed with a phenomelogical
attitude making the rspondents express their experiences
and deeper feelings. The central idea was openness and
therefore the questions were not directed. After the
interview, the psychiatrist provides the researcher a
written report of the interview with her recommendations
for the donor regarding kidney donation. The text was
analyzed using a phenomelogical approach developed by
Karlsson in 1993. The analysis results in therretical
statements that respond to the research question and the
statements are validated by direct quotations from the
interviews.
Results: Motivation is a complex of subjective
feelings. The five categories of motives found in this
study were revealed in different combinations for each
individual subjects. In majority of the cases, donors
expressed their desire in helping others. To gain financial
rewards from the act of giving was equally seen in each
subject in this study. One case did donate out of
gratitude and another as an act of sacrifice for his family
by donating for another person.
Financial gain has been the primary motivating
factor among living non-related kidney donors at 87% (21
cases). Finances to sustain basic necessities of daily
living of the family predominates at 37% (9 cases)
followed by need to support educational needs of the
children at 25% (6 cases). Four cases (16.7%) were
unable to specify reasons for the need of monetary gain
that suggest having no definite plans prior to
transplantation.
Conclusion: There is an evident social pressure
for financial gain in the act of donation among living nonrelated
organ donors. Though they are not literally being
forced into donation, but the opportunity that lies before
them for a chance to get “large” enough money to start a
living is undeniable.
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