In 1998, India accounted for 1% of road vehicles worldwide and 6% of road accidents worldwide.  These accidents increased by 10% in 2006. The total number of road accidents is about 90,000 per year and, in 2005, Tamil Nadu reported 13,000 road traffic deaths.  In nearly 40-50% of all fatal road accidents worldwide, the cause of death is caused by head injuries that potential organ donors in India leave alone because of road accidents. Other causes of brain death such as subarachnoides and brain tumor bleeding could add more numbers. Even if 5 to 10% of deceased patients became organ donors, this would mean that a living person would not need to donate an organ. Promoting the now defunct donation program would help not only kidney transplants, but also liver, heart, abdomen and lung transplants to thrive in the country. On the other hand, in the case of an unaddreaded donation, the potential living donor does not know the recipient, which may lead the potential donor to consider different benefits and risks for the recipient and the donor. In undirected donations, there are two recipients of concern: the recipient of the donor organ and the expected recipient of the donor who will benefit from the donor`s donation. However, studies do not show significant differences between targeted and non-target donors in their demographic profiles and physical and psychosocial outcomes21,22 In a case where A and B have a negative attitude towards organ restitution, both parties agree and there is no conflict. Contrary to the above, no valuable consideration is knowingly acquired, received or transmitted for the donation of the kidneys.
It is important to note that the paper focuses on, and the conclusion concerns the donor and recipient. The donation of living organs is one of the most demanding subjects in medicine and requires the participation of doctors. If one of our main offers is « do no harm », doctors and surgeons can only continue to transplant living organs if there is a minimal risk or a damaging risk and a great benefit. The ethics of transplantation take into account the risk-benefit analysis, both for the donor and for the recipient. If the proposed kidney removal was known to cause donor kidney failure, doctors would not be able to participate in this ethical action. This risk to the donor would outweigh the benefits to the donor. However, the same point can be made about the legitimacy of the treaty, which requires B to return the transplanted organ. Let`s look at the following case: B, who prioritizes short-term gain (receiving an organ), presents a contract that defines his obligation to return the organ to A, and says, « Please give me your kidney now, and I promise I will return it to you if you ever need it again. » Or in another case, A could approach the contract by saying, « I will give you my kidney (B) if you agree to give it back to me, if I need it. If B responds to this offer, he may not have given sufficient consideration to the contract, overestimated its short-term benefits and underestimated the likelihood of the reality that requires him to return the organ to A. In addition, this contract places B in a vulnerable position as a receptor for the original kidney transplant (from A to B).
It is possible that B reluctantly accepts, although he finds the treaty offensive. Under this implicit pressure, the treaty is not considered binding. « authentic contract, » a contract without default or on the basis of consent to mutual respect for personality between A and B. In other words, here, the contract and consent are autonomous, and the condition is that they be voluntary, which means that there is no forced intervention on the part of a third party, and no exploitation.