Potential living organ donors who describe religious motivations as the basis for their donation, particularly in the absence of an emotional or genetic connection to the intended recipient, raise challenges for the transplant team who are more comfortable in assessing relational motivations than religious ones. This article provides a composite case scenario to illustrate some of the biases that may interfere with the assessment of the donor motivated by religious altruism and how religious altruism may be pathologized. The clinical challenges in assessing the religiously altruistic potential living donor are reviewed. Religious approaches to altruism and their implications for living organ donation are reviewed for a sample of the major world religions.
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