A 42-year-old man with end-stage renal disease is being evaluated for a living-donor kidney transplant. His potential donor is his 38-year-old brother. The recipient’s wife has been acting as the interpreter for both men during clinic visits, as the family shares a close relationship and prefers to keep communication “within the family.”Conflict of Interest in Use of an Interpreter The wife has dual roles—interpreter and family member—creating a conflict that compromises accurate, impartial communication. Donor Autonomy and Informed Consent The donor must receive clear, complete, unbiased information about any factors that could affect the transplant outcome. Lack of transparency prevents informed consent Recipient Confidentiality vs. Donor Safety The recipient has the right to privacy, yet the transplant team also has an ethical obligation to protect the donor from foreseeable risk (risk–benefit assessment.) Family Dynamics and Undue Influence The close relationship among all parties increases the risk of emotional pressure, even unintentionally. Using a family member as interpreter can mask coercionDuring the discussion privately, the wife/interpreter informs the transplant team of a significant health condition affecting the recipient—one that may influence graft outcomes and long-term survival. She insists that this information not be disclosed to the donor, expressing concern that the brother will withdraw his offer to donate. The donor appears motivated and supported by both his brother (the recipient) and the recipient’s wife. He feels well-informed and confident that he understands the medical implications of donation.Arrange a neutral interpreter to remove conflict of interest. Privately counsel the recipient about the necessity of disclosure. Ensure the donor undergoes an independent donor advocate assessment to confirm voluntariness and understanding. If the recipient refuses disclosure, the team may ethically decline to proceed with the transplant.This case underscores the essential role of professional interpreters, independent donor advocacy, and structured communication protocols in transplant evaluations. When informed consent cannot be guaranteed, the transplant team may be ethically obligated to pause or decline proceeding with the donation.There is need for clear institutional guidelines and reinforces the central ethical principles of autonomy, transparency, and protection of donor welfare in living kidney transplantation.