They talk the talk: Surveying attitudes and judging behavior about living anonymous kidney donation

Over the past 30 years, numerous studies have reported that some individuals are willing to donate a kidney anonymously to a stranger; however, intentions are poor predictors of behavior. We surveyed individuals interested in being living anonymous donors (LADs), exposed them to an interview paralleling live-donor assessment, and measured their LAD commitment. Personality and donation decision factors were examined to corroborate cases of attitudinal and behavioral congruency. A telephone survey of 1,002 randomly selected adults living in Vancouver, British Columbia, asked respondents how willing they were to donate a kidney, while alive, to particular individuals including a stranger. A subsample participated in a follow-up, which involved completing a mailed questionnaire and taking part in an in-depth interview. Expert raters judged respondents' commitment to being a LAD on the basis of the interviews. Two hundred fifty-eight (26%) of those surveyed stated they would probably or definitely be willing to donate a kidney to a stranger. Fifty-two completed the follow-up. Sixteen of the 52 (31%) were judged to be "committed LADs." No demographic differences were found between the committed LADs and the 33 remaining "noncommitted participants." The committed LADs differed significantly from the noncommitted participants on personality measures and donation decision factors. These differences underscore the latter group's anonymous donation commitment. This study brings into focus the potential for a significant number of individuals coming forward as potential LAD candidates if they are informed about the need and given unbiased information about the procedure. We believe there is ethical latitude in allowing the promotion of LAD donation by interested third parties such as patient advocacy groups and professional bodies. We advocate public awareness of LAD programs as a first step followed thereafter by more provocative measures to engage the public in this endeavor.