The aim of this study was to analyse how prospective altruistic kidney donors construct their decision to donate, and to explore meaning-making, subjective experience and practices that are made available to the donor and others through discourse. A genealogical approach to existing literature was taken. A multiple-case study design and biographical-narrative, semi-structured interviews aimed to produce text for analysis on two levels. These were; the social implications for subjectivity and practice, and a tentative, psychodynamic theory-driven explanation of the participants' psychological investment in the discourses they used. Six prospective altruistic kidney donors were interviewed. In-depth discourse analysis integrated Foucauldian, psycho-discursive and psychosocial approaches. Psychodynamic theory was applied to sections of the text in which participants seemed to have particular emotional investment. Discourse analysis generated three major discursive themes: other-oriented, rational and self-oriented discourses. Participants used discourses to position themselves as concerned with the needs of the recipient, to resist questioning and criticism, and to demonstrate the rationality of donating. Participants' own needs were largely rejected. Psychodynamically informed analysis suggested that altruistic donation was experienced by donors as compelling and could be theorized as unconscious communication. Results suggested that using the term "altruistic" for living, non-directed organ donation constrains available discourses, severely limiting what can be said, felt, thought and done by donors, clinicians and the public. This study demonstrated the compatibility and usefulness of counselling psychology and psychosocial methodology when it is applied to the interface between the individual, the clinic and society.EThOS - Electronic Theses Online ServiceGBUnited Kingdo