Ritual, Not Material Objects: Living Organ Transplantation from the Perspective of Gift-Giving in Confucian Thought

Living organ transplantation requires ethical reflection on the relational dynamics embedded behind the flow of organs. In the Confucian concept of gift-giving, living organs are regarded as ritual gifts rather than mere objects, reflecting the ethical tangibility and productive nature of transplantation practices in China. Framed as "gifts of life," the donation and reciprocal processes of living organs embody the unique familial practices of ren (benevolence) and li (ritual propriety). At the level of giving, the organ as a ritual gift reflects "hierarchical love" and the "reproduction of mixed relationships"; at the level of reciprocity, it expresses both "repaying with benevolence" and the embodiment of ren through one's actions. The ritual practices of living organ donation undergo dynamic development in the context of life and Confucian ethics.