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(1) Because donors are initially healthy and then are exposed to potential harms, they require special safeguards.Accordingly, every donor should be assigned an advocate team that includes a physician.This includes a psychosocial evaluation of the potential donor to identify disqualifying factors, address specific needs and explore potential motivations to donate.

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From the outset, all involved parties must agree that the reasons why any potential donor does not donate will remain confidential for the potential donor’s protection.

In situations of paired, domino, or chain donation withdrawal must still be permitted.

This team is primarily concerned with the well-being of the donor.

Though some individuals on the donor advocate team may participate in the care of the recipient, this team ideally should be as independent as possible from those caring for the recipient.

Informed consent for donation is distinct from informed consent for the actual surgery to remove the organ.

(i) The potential donor must have decision-making capacity, and the decision to donate must be free from undue pressure.Physicians should make special efforts to present a clear and comprehensive description of the commitment being made by the donor and the implications for other parties to the paired donation during the informed consent process.(c) Living donation should never be considered if the best medical judgment indicates that transplantation cannot reasonably be expected to yield the intended clinical benefit or achieve agreed on goals for care for the intended recipient.The medical profession has pursued living donation because the lives and quality of life of patients with end-stage organ failure depend on the availability of transplantable organs and some individuals are willing to donate the needed organs.This practice is consistent with the goals of the profession—treating illness and alleviating suffering—only insofar as the benefits to both donor and recipient outweigh the risks to both.Issued prior to April 1977; updated June 1994 based on the report adopted June 1993.