Introducing an Exploitation/Fair Dealings Scale for Evaluating Living Organ Donor Policies Using Iran as the Test Case

• DOI: http://doi.org/10.1002/wmh3.264
• Published date: 01 June 2018
• Date: 01 June 2018

Introducing an Exploitation/Fair Dealings Scale for

Evaluating Living Organ Donor Policies Using Iran

as the Test Case

Sigrid Fry-Revere , Deborah Chen, Bahar Bastani, Simin Golestani,

Rachana Agarwal, Howsikan Kugathasan, and Melissa Le

This article presents a tool for evaluating whether living organ donor systems are exploitive or fair

to donors. The exploitation/fair dealing scale introduced in this article relies on broadly accepted

notions of exploitation and fair dealing from U.S. bioethics literature and U.S. jurisprudence. The

10-factor/14-point scale derived from those concepts is then applied to Iran as an illustrative

example. It is our hope that the scale will be useful for evaluating living organ donor policies

around the world.

KEY WORDS: health policy, living organ donation, transplant ethics

Introduction

As the organ shortage continues to worsen and there is an increased focus on

living organ donation, policymakers need to f‌ind ways to ensure that living organ

donors are treated fairly. We believe it is time for a tool that evaluates not the

effectiveness of living organ donor policies around the world, but their fairness

from the donor’s perspective. While a more objective measure would be useful,

whatever measure is applied to judge living organ donor practices, it should not

neglect the donor’s own experiences. Measuring whether donors feel exploited or

treated fairly is an important step in determining whether the system in which

they participated is worth emulating. Additionally, close evaluation of the

individual factors that contribute to either exploitation or fair dealing may be

instructive for considering how to improve a country’s living organ donor

program.

We could have chosen any country as our sample case for illustrating how

our exploitation/fair dealing tool works, but we chose Iran for three reasons.

First, Iran has had one of the world’s most effective living organ donor programs

(in terms of the number of living organ donors per million) when averaged over

World Medical & Health Policy, Vol. 10, No. 2, 2018

180

doi: 10.1002/wmh3.264

#2018 Policy Studies Organization