ABSTRACT
Personal values and beliefs, including beliefs about altruism and responsibility, are obviously involved in people's decision-making about donating an organ. The relevance of medico-scientific and social factors that constitute the context of the donation-transplantation decision cannot be disputed. When the decision-maker makes a convincing appeal to a deeply held, though perhaps idiosyncratic, value system, the decision should receive the prima facie respect of the bioethical and medical communities. Medicine is supposed to be governed by the norm: "first, do no harm". Of course, medical procedures often involve doing some harm for the greater benefit of the patient. Incisions are made to remove the tumor; side effects of chemotherapy are imposed and endured with the hope of cure or prevention of recurrence. One additional constraint must be observed: the harm imposed must be the minimum harm that can be imposed to achieve the desired benefit.
