The decision making process undertaken by a sibling who chooses not to
donate a kidney to a brother or sister who needs a transplant is the
subject of this article. Presented from the perspective of the potenti
al donor client, the paper focuses on the moral and ethical concerns i
ndicated when there are two equal but competing rights involved in the
decision. It also addresses pertinent attitudinal dimensions and soci
al and health issues that affect all parties-the client, the marital p
artner, the family of origin, and the patient's immediate family. The
article concludes by addressing ''what'' and ''how'' social workers as
sist clients after the difficult decision not to donate has been made.