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Directed altruistic living donation: what is wrong with the beauty contest?
  1. Greg Moorlock
  1. Correspondence to Dr Greg Moorlock, Medicine, Ethics, Society and History, University of Birmingham, 90 Vincent Drive, Edgbaston, Birmingham B15 2TT, UK; g.j.moorlock{at}


This paper explores the specific criticism of directed altruistic living organ donation that it creates a ‘beauty contest’ between potential recipients of organs. The notion of the beauty contest in transplantation was recently used by Neidich et al who stated that ‘[a]ltruism should be the guiding motivation for all donations, and when it [is], there is no place for a beauty contest’. I examine this beauty contest objection from two perspectives. First, I argue that, when considered against the behaviour of donors, this objection cannot be consistently raised without also objecting to other common aspects of organ donation. I then explore the beauty contest objection from the perspective of recipients, and argue that if the beauty contest is objectionable, it is because of a tension between recipient behaviour and the altruism that supposedly underpins the donation system. I conclude by briefly questioning the importance of this tension in light of the organ shortage.

  • Transplantation
  • Allocation of Organs/Tissues
  • Donation/Procurement of Organs/Tissues

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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