Primum Non Nocere: Beneficent Deception

Abstract

The use of the blameless medical excuse in organ transplantation is intended to provide an immediate shield against strong pressures that reluctant potential donors might feel to go through with living organ donation. The excuse elaborates a substantially false or exaggerated anatomical or physiological reason why the potential donor is not a good candidate for donation medically. Thus it is intended to protect reluctant potential donors' privacy and confidentiality by masking from the potential organ recipient the fact that they do not wish to go through with the donation. However, because the excuse involves the presentation of that which is false as true, it puts transplant physicians in the position of engaging in - or at least being complicit in - the intentional deception of patients. This paper considers various ethical and legal issues that may arise from of the use of such deception in the context of organ transplantation.

Keywords: organ transplantation, medical excuse, deception, beneficence, legal ethics, coercion