**2. Utility**

Morality requires that we do not only avoid harming people and regard them as autonomous but also contribute to the well-being of other people. This is expressed under the title of "utility". Apart from avoiding harming others, people should take positive steps to help other people. The utility can be examined under the "positive utility" heading, which refers to the action of the subject to provide some benefits to others, and utility, which requires the subject to establish a balance between benefits, risks, and costs to achieve the best overall results [7]. Regarding our subject, it is necessary to talk about the utility and saving duty for the specific (i.e. for certain people) rather than the general benefit.

General utility targets all persons regardless of special relationships. The utility specific to persons emerging as a result of moral relationships, contracts, and special ties usually applies to certain persons, such as our children, friends, parties to the contract, or patients. Although the idea that we have an obligation to all people is controversial, almost everyone agrees with the idea that we have an obligation to act for the benefit of the people with whom we have special relationships [7].

Beauchamp and Childress argues that the "duty to save" requires an obligation to provide a prima facie utility if all of the following conditions are met, even if close moral relationships based on specific agreements or family and friendship ties are excluded.


In the light of these evaluations of Beauchamp and Childress, the 4th condition constitutes the debate on whether living donors who have a special contract for organ transplantation or have family and friendship ties have an obligatory saving mission. If we do not consider a person's donation of a kidney as "a critical risk, cost, or burden", then we put potential living donors under obligatory duty to save. Putting the living donor, who will only have moral gains, under the direct obligation of compulsory saving would be a point in contradiction with the concept of volunteering. Also, another issue to discuss is which of the individuals who meet these conditions and have a family, friend, or special contractual relationships with the recipient will fulfill this obligation first.

It should be noted that the obligation to save is at the core of why living organ donors mostly donate organs to their relatives (family, friends, relatives, etc.). Even if the conditions stated by Beauchamp & Childress are met, it is a matter of debate whether we have an obligation to save people we do not know, especially in terms of organ transplantation. The fact that people hesitate to donate living organs to patients they do not know can be shown as evidence of this matter. Expecting such a sacrifice from the whole society will not go beyond pursuing a high ideal.

Balancing the duties of providing utility and doing no harm with the principles of respect for autonomy and justice is accepted as essential [8]. This balance requires the determination of the capacity and autonomy of living organ donors and the careful examination of the stages that require their voluntary consent.

In this context, the volunteering of living donors who want to give a "new life" to their family, friend, or someone they do not know as a living organ donor should be determined well, and the special utility action of the person should be ethically assessed within the concept of obligation to save.

The majority of scientists studying living organ donation ethics have reached a consensus on the issue that giving a certain level of harm to competent volunteers to save another person's life requires that a valid consent for the donation is available, living organ donation provides a general positive balance of harm and benefit that cannot be achieved in a way that is less damaging to donors and recipients, and that the donation does not lead to significant and long-term morbidity or mortality of the donor.

Altruism, which is also a piece of modesty, is the ability of a person to prefer someone else's purposes and desires over their own purposes and desires. Altruism, which is the most important factor underlying the expression of volunteering, is one of the basic principles of organ transplantation.
