"Let Them Help You, They Too Want to Touch the Seams of the Gown of This Majestic Act": Motives of Non-Direct (altruistic) Kidney Donors

Non-direct kidney (altruistic) donations are a medically recommended therapeutic method for those suffering from end-stage renal failure, with significant benefits for both the recipient and the health system. Worldwide, this type of donation is scarce, thus constituting a rare solution for an increasing health challenge. Israel ranks highest in non-direct kidney donations, with the majority of donors belonging to the various Jewish orthodox communities. To better understand the motives of these donors, we conducted qualitative research delving into the social constructs and shared meanings that shape donors' perspectives and experiences.

A thematic analysis was conducted, including 69 articles from 31 biannual magazines published by Matnat Chaim, an organization promoting altruistic kidney donations in Israel. Each article depicting the story of a donor was sampled from different periods since the establishment of the organization, and considering the different editions geared towards various relevant audiences.

The findings align with previous studies on donor motivations, highlighting two primary themes: the desire to help others in distress, and religious/spiritual motivations. Albeit less overt, an additional major theme was identified relating to social relationships and environmental factors as motivators for donation. The relational aspects from the donors' point of experience encompass a spectrum of relationships spanning from that with the recipient, through the relationship with the donors' bonding social capital and with divinity. This insight suggests that donors' social networks and their position within broader societal structures, play a crucial role in their decision to donate.

This research's novel insights of the motives of non-direct kidney donors imply that their decision is not solely based on an altruistic discourse, but also shaped by social forces and deeper relational factors. Health systems can benefit from the understanding of the complexity of donor motives, and better support them throughout the donation process.