BACKGROUND The bioethical debates concerning living donation and surrogacy revolve around similar ethical questions and moral concepts. Nevertheless, the ethical discourses in both fields grew largely isolated from each other. METHODS Based on a review of ethical, sociological and anthropological research this paper aims to link the ethical discourses on living kidney donation and surrogacy by providing a comparative analysis of the two practices' relational dimension with regard to three aspects, i.e. the normative role of relational dynamics, social norms and gender roles, and reciprocity. Based on this analysis, we derive conclusions for the framing of living organ donation and surrogacy in ethical theory and practice. RESULTS First, our analysis emphasizes the relevance of acknowledging the complex relational implications of living kidney donation and surrogacy. Underestimating this relational dimension may not only lead to individual crises but endanger existing as well as newly emerging familial relationships. Second, we point out differences in the normative assessment of social norms and gender roles in the ethical debates about living kidney donation and surrogacy. In particular, we show how different evaluations of altruism affect the understanding of autonomy in both contexts. In addition, we sensitize for biased perceptions of gender roles. Finally, we argue that challenges resulting from unresolved reciprocity are an issue in living kidney donation and surrogacy independent of whether the exchange of body parts or bodily services is framed as a gift or commercial exchange. By pointing out the limits of financial compensation, we stress the relevance of non-material, relational rewards as potential remedy.

中文翻译：

---

活体肾脏捐献和代孕的伦理比较：了解关系维度。

背景技术关于生活捐赠和代孕的生物伦理学争论围绕着相似的伦理学问题和道德观念。但是，这两个领域的道德论述在很大程度上彼此隔离。方法基于对伦理，社会学和人类学研究的回顾，本文旨在通过对三个实践的关系维度的三个方面（即关系的规范作用）进行比较分析，将有关活体肾脏捐赠和代孕的伦理学论述联系起来动态，社会规范和性别角色以及互惠。在此基础上，我们从伦理学理论和实践中得出了活体器官捐赠和代孕框架的结论。结果首先，我们的分析强调了承认活体肾脏捐赠和代孕的复杂关系的重要性。低估这种关系维度不仅可能导致个人危机，而且会威胁到现有的和新兴的家庭关系。第二，我们指出在关于活体肾脏捐赠和代孕的伦理辩论中，对社会规范和性别角色的规范评估存在差异。特别是，我们展示了利他主义的不同评价如何在两种情况下影响对自治的理解。此外，我们对性别角色的偏见敏感。最后，我们认为，未解决的互惠所带来的挑战是活体肾脏捐赠和代孕中的一个问题，而与身体部位或身体服务的交换是作为礼物还是商业交易无关。通过指出经济补偿的局限性，我们强调了非物质的，相关的奖励作为潜在补救措施的重要性。