Table 1

Checklist for interviews with donors for living related liver transplantation

(1) General profile of the recipient and the donor
    (a) A brief medical history of the recipient
    (b) Family tree
(2) Informed consent
    (a) When and how did you come to know about living related donor liver transplant?
    (b) Who explained the details of the transplant surgery, and how many times?
    (c) Under what circumstances (one to one, or with others present)?
    (d) Do you clearly understand the procedure of the surgery?
    (e) Do you fully understand the risks and benefits of the treatment (including short term and long term risks for the donor, and the success rate of graft attachment for the recipient)?
    (f) Have you been given information and explanations about alternative therapies?
    (g) Have you been given enough time to ask questions? Have you been invited to ask questions?
(3) Decision making process
    (a) Have you consulted with anyone?
    (b) Was there any coercion by other family members or relatives? (For example, if you do not agree to be a donor, the patient will surely die.)
    (c) Is your decision completely voluntary?
(4) Psychosocial aspects
    (a) Do you have any anxiety about your surgery?
    (b) Do you have any problems in your life (for example, business or social relationships)?
    (c) Do you have any financial problems?
(5) Protection of the donor's right
    (a) You have the right to refuse or withdraw your consent until the last moment.
    (b) You will not suffer any disadvantage if you decide to refuse or withdrawal.
Interviewer's assessment
    (1) The donor is well informed. □Yes □No
    (2) The donor has a good understandings of the entire process. □Yes □No
    (3) The donor is fully capable of making a decision. □Yes □No
    (4) The donor's decision is completely voluntary and firm. □Yes □No
    (5) The decision has been reached without any evidence of coercion. □Yes □No
    (6) The donor's right has been fully protected. □Yes □No
    (7) The donor is without significant psychosocial problems. □Yes □No
Time of interview min
Interviewer's signature (a member of ethics committee)
Date