City Research Online

'It seemed churlish not to': How living non-directed kidney donors construct their altruism

Challenor, J. & Watts, J. (2013). 'It seemed churlish not to': How living non-directed kidney donors construct their altruism. Health, 18(4), pp. 388-405. doi: 10.1177/1363459313501358


Our objective was to explore how prospective altruistic kidney donors construct their decision to donate. Using a qualitative design and biographical-narrative semistructured interviews, we aimed to produce text for analysis on two levels: the social implications for subjectivity and practice and a tentative psychodynamic explanation of the participants’ psychological investment in the discourses they used. A total of six prospective altruistic kidney donors were interviewed. A psychosocial approach to the analysis was taken. In-depth discourse analysis integrated Foucauldian with psychodiscursive approaches and psychodynamic theory was applied to sections of text in which participants seemed to have particular emotional investment. Analysis generated three major discursive themes: other-oriented, rational and self-oriented discourses. The desire to donate was experienced as compelling by participants. Participants used discourses to position themselves as concerned with the needs of the recipient, to resist questioning and criticism, and to manage difficult feelings around mortality. Participants tended to reject personal motivations for altruistic donation, positioning relatives’ disapproval as selfish and illogical. These results suggest that the term ‘altruistic’ for living non-directed organ donation constrains available discourses, severely limiting what can be said, felt, thought and done by donors, clinicians and the public. A more useful approach would acknowledge potential psychological motives and gains for the donor.

Publication Type: Article
Additional Information: Copyright Sage 2013
Publisher Keywords: altruistic kidney donation, discourse analysis, organ donation, psychosocial method
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences > Psychology
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