Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T14:06:45.503Z Has data issue: false hasContentIssue false
  • English
  • Français

Altruism in Medicine: Its Definition, Nature, and Dilemmas

Published online by Cambridge University Press:  12 March 2010

DAVID STEINBERG
Get access Rights & Permissions [Opens in a new window]

Extract

A significant portion of the practice of medicine is dependent on individual acts of medical altruism. Many of these acts, such as the donation of blood, gametes, stem cells, and organs, entail varying degrees of bodily intrusion and, for the altruist, various combinations of discomfort, risk, and expense. Discussion of the ethics of altruism has typically been fragmented under various rubrics such as blood donation, organ and tissue transplantation, health information, and the assisted reproductive technologies. The ethics of these specific examples of altruism are best explored in conjunction with a broader discussion of their relatively neglected mother discipline, altruism in medicine.

Type
Dissecting Bioethics
Information
Cambridge Quarterly of Healthcare Ethics , Volume 19 , Issue 2 , April 2010 , pp. 249 - 257
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Health information altruists allow correlation between their genetic and phenotypic information.

2. Medical research, which is often altruistic and may involve bodily intrusion, has been widely discussed in its own right and is not a subject of this discussion.

3. Simmons RG. Altruism and sociology. Sociological Quarterly 1991;32(1):1–22.

4. Monroe KR. Explicating altruism. In: Stephen GP, Underwood LG, Schloss JP, Hurlbut WB. Altruism and Altruistic Love. Oxford: Oxford University Press; 2002.

5. Nagel T. The Possibility of Altruism. Princeton, NJ: Princeton University Press; 1970.

6. Baier K. Egoism. In: Singer P, ed. A Companion to Ethics. Oxford: Blackwell Publishing; 1993:197.

7. Joyce R. The Evolution of Morality. Cambridge, MA: MIT Press; 2007:14.

8. Titmuss RM. The Gift Relationship: From Human Blood To Social Policy. New York: Pantheon Press; 1971:225–6.

9. Raymond JG. Reproductive gift giving: The altruistic woman. Hastings Center Report 1990;20:7–11.

10. Spar D. The egg trade-making sense of the market for human oocytes. New England Journal of Medicine 2007;356(13):1289–91.

11. American Red Cross North Central Blood Services. News release. 18 Oct 2004; http://www.uhhs.com/displaycontent.aspx?pageid=375&MID=5 (last accessed 1 Feb 2005); http://lifesouth.org/AssetsLifeSouth/DonorChairPerson/cholesterol.pdf (last accessed 21 Jan 2008); East Texas News 9 Sep 2007.

12. Delmonico FL, Arnold R, Scheper-Hughes N, Siminoff LA, Kahn J. Ethical incentives—not payment—for organ donation. New England Journal of Medicine 2002;346:2002–5.

13. The context for these illustrative dollar amounts is the average American wage earner who is not under economic duress. The significance of a dollar amount will vary between persons and economies.

14. The Ethics Committee of the American Society of Reproductive Medicine. Financial incentives in recruitment of oocyte donors. Fertility and Sterility 2004;82(Suppl. 1):S240–4.

15. Mead R. Eggs for sale. New Yorker 1999 Aug 9:56–65.

16. http://www.eggdonation.com/SampleDonor/Donor1.html (last accessed 28 Oct 2007).

17. Weller S. Is this egg worth $50,000? SELF Magazine 2000;Dec:163.

18. In 2004, there were 15,175 attempts to become pregnant using someone else's eggs, resulting in 5,449 babies (The New York Times Magazine 15 Jul 2007). Only a minority of these egg donations could be considered altruistic.

19. Post SG. The tradition of agape. In: Post SG, Underwood LG, Schloss J, Hurlbut WB, eds. Altruism and Altruistic Love: Science, Philosophy & Religion in Dialogue. New York: Oxford University Press; 2002:51–64.

20. See note 19, Post 2002:54 and 65.

21. Habito RF. Compassion out of wisdom: Buddhist perspectives from the past toward the human future. In: Post SG, Underwood LG, Schloss J, Hurlbut WB, eds. Altruism and Altruistic Love: Science, Philosophy & Religion in Dialogue. New York: Oxford University Press; 2002:362–78.

22. See note 5, Nagel 1970.

23. Oliner SP, Oliner PM. The Altruistic Personality. New York: Free Press; 1988.

24. See note 4, Monroe 2002:106 and 109.

25. See note 3, Simmons 1991.

26. Mauss M. The Gift: The Form and Reason for Exchange in Archaic Societies. New York: WW Norton; 2000.

27. Wright R. The Moral Animal: Why We Are the Way We Are; The New Science of Evolutionary Psychology. New York: Vintage Books; 1995.

28. Trivers RL. The evolution of reciprocal altruism. The Quarterly Review of Biology 1971;46:39-43 and 35-57.

29. See note 28, Trivers 1971:46.

30. Fehr E, Gachter S. Altruistic punishment in humans. Nature 2002;415:137–40.

31. See note 28, Trivers 1971.

32. Wilson DS, Wilson EO. Rethinking the theoretical foundation of sociobiology. Quarterly Review of Biology 2007;82:327–48.

33. Dawkins R. The Selfish Gene. Oxford: Oxford University Press; 1989:88–108.

34. Wilson EO. On Human Nature. Cambridge, MA: Harvard University Press; 1978:167.

35. Scheper-Hughes N. The tryanny of the gift: Sacrificial violence in living donor transplants. American Journal of Transplantation 2007;7:507–11.

36. See note 9, Raymond 1990.

37. Pollock A. Complicating power in high-tech reproduction: Narratives of anonymous paid egg donors. Journal of Medical Humanities 2003;24:241–63.

38. Steinberg D. How much risk can medicine allow a willing altruist? The Journal of Clinical Ethics 2007;18(1):12–7.

39. Steinberg D. Kidney transplants from young children and the mentally retarded. Theoretical Medicine and Bioethics 2004;25(4):229–41; Steinberg D, Pomfret EA. A novel boundary issue: Should a patient be an organ donor for their physician? Journal of Medical Ethics 2008;34:772–4.

40. Hanto DW. Ethical challenges posed by the solicitation of deceased and living organ donors. New England Journal of Medicine 2007;356:1062–6.

41. Valapour M. Informed consent among live organ donors. University of Minnesota Examiner 2008;11(3):1–2.

42. Steinberg D. An opting in paradigm for kidney transplantation. American Journal of Bioethics 2004;4(4):1–11

43. Steinberg D. The allocation of organs donated by altruistic strangers. Annals of Internal Medicine 2006;145:197–203.

44. Katz RA. Who should capture the value of donated tissue? In: Steinberg S, ed. Biomedical Ethics: A Multidisciplinary Approach to Moral Issues in Medicine and Biology. Hanover, NH: University Press of New England; 2007:306–9.