Informed Consent and Framework of Living Donor Care

Living kidney donation is ethically unique because the donor undergoes nephrectomy, with associated risks and consequences, to provide medical benefit to another person. In this chapter, we discuss an ethical framework that ensures a meaningful informed consent process for donor candidates. We explore the benefits of independent donor team members, including the role of the independent living donor advocate that has been adopted in some countries, including the United States. We outline fundamental elements of living kidney donor informed consent, including content domains and methods for disclosure, and highlight the essential balance between honoring the principles of patient autonomy, beneficence, and non-maleficence. We describe special considerations for vulnerable populations, offer illustrative case scenarios, and present an agenda for future research.