More on parental living liver donation for children with fulminant hepatic failure: addressing concerns about competing interests, coercion, consent and balancing acts.

Parental living liver donation for children with fulminant hepatic failure raises complex ethical issues. According to a recent editorial in this journal, these include contradictory interests, the possibility of coercion and compromised consent and the need to balance the risks to the donor against the potential benefits for the recipient. Here I argue that in this setting, interests are often aligned rather than conflicted, that coercion of parental donors is rare, that consent may sometimes be valid even when it is not fully informed and that the correct balance to consider is the relative weights of risks and benefits for the donor. I conclude that living liver donation by parents of children with fulminant hepatic failure is consistent with societal norms of parental behavior, ethically acceptable and should be permitted regardless of the efficiency of the deceased donor organ recovery program.