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Context and objective: Living kidney donation accounts for approximately half of all kidney transplantation in many countries and is central to health policy focused on increasing organ supply. However, little examination of the economic consequences of living kidney donation has been undertaken from the perspective of donors themselves. This article documents living kidney donors’ views regarding recompense and payment for organ donation, based on their experience. Participants: Twenty‐five living kidney donors from New Zealand participated in this study. Methods: This qualitative study, based on thematic analysis, uses semi‐structured in‐depth interviews to examine the experiences of living kidney donors. Themes were organized around altruism and the ‘gift’, perceptions of shared corporeality and identity, and donor support. Results: Most participants agreed the donation process was costly in terms of time and money. Many incurred personal costs, and some experienced financial hardship. All the participants viewed financial hardship as a barrier to organ donation and favoured recompense for direct and indirect costs. Most did not support payment for organs, and none supported commercialization. Discussion and conclusions: The findings show that framing organ donation as a ‘gift’ can stymie discussion about reciprocity, remuneration and exchange, making talk about financial recompense difficult. Financial well‐being, nonetheless, has implications for the ability to care for self and others post‐operatively. We conclude that the economic consequences for living kidney donors in jurisdictions where recompense for direct and indirect costs is insufficient are unfair. Review of financial assistance for live organ donors is therefore recommended. [ABSTRACT FROM AUTHOR]

The “gift of life” metaphor is used to promote organ donation where commercialization is prohibited. In this article, we explore how multiple parties involved in organ transfer procedures think of gift terminology by drawing on interview data with transplantation specialists, organ transplant recipients, living directed donors and living nondirected donors. The interviews took place across New Zealand between October 2008 and May 2012, in participants’ homes and hospital workplaces. The interviews were transcribed verbatim, coded manually, and thematically analyzed. Although gift language is often viewed as clear-cut, the gift trope has multiple meanings for different constituent and cultural groups, ranging from positive descriptors to obscuring and romanticizing the complexities of transplantation processes. To account for these multiple perspectives, we suggest new ethical models to capture the nuanced phenomenon of organ transfer in ways that recognize the full range of donation and reception experiences. [ABSTRACT FROM AUTHOR]

Living kidney donation is an alternative treatment option for end-stage renal failure. Prospective donors are protected from risk by counselling and assessment processes, to ensure they are fully informed about all the stages of donation. Drawing on in-depth interviews with 25 living kidney donors from across New Zealand, this article discusses donors' experience of the pre-donation screening process, donation workup coordination, psychological preparation, and post-operative follow-up care and support. In particular, the article examines donor perceptions of the informed consent process. The findings indicate that donors' experience of the consent process may be at odds with the New Zealand Code of Health and Disability Services Consumers' Rights 1996. Instead of a primary healthcare focus on the threshold elements of informed consent, this study indicates that more effort should be made to adequately inform donors and to clearly spell out each stage of the donation process to better meet donors' needs. [ABSTRACT FROM AUTHOR]