Gift of self: Determination of the role of rationality in organ donation.

摘要

The organ procurement and transplantation system in the U.S. struggles with the social challenge of officially sanctioned and distinctively personal gifting of donor organs. Because of an extraordinary mix of technical advances and policy underpinned with ethical considerations combined with the inadequate rate of commitment, a tremendous disparity in donor organ need and availability exists today.;Conventional wisdom holds that altruism is central to donor intent and is thus a focal point in donor awareness education. Altruism, however, does not explain all behavior regarding donor intent as many individuals either decide against, or make no decision, regarding donation. This dissertation introduces an alternative rational approach in exploring the perceptual justification in a decision regarding donor commitment in order to provide a unique model for public education in donor awareness. A mixed model of the rational choice perspective is applied to the explanatory factors of self-interest, altruism, donor incentives, fairness in allocation, and knowledge about the rules and regulations that govern donor behavior. Research findings conclude that rationality, as it pertains to norm-based preference-ordering, has a role in donor intent. However, the centrality of altruism in organ donation should not be dismissed. Instead, the findings suggest that we should continue to clarify the compelling forces in a decision regarding donor intent.;If public education in donor awareness incorporates an assumption of rationality, that is, that people are concerned about personal benefit in beneficent action---as a self-interested preference, a concern about equity and fairness, or an interest in learning more about the donor system, these explanatory factors can be nurtured and have the potential to positively affect the rate of donor commitment.