The other day a friend asked if I would be a kidney donor were I able. “Yes, of course; I think I’d even like to be an anonymous donor,” I immediately answered before I spotted the trap: “Well, then what’s your problem with accepting one?”
Stumped.
Oh, I ran though my list of reasons: it’s unethical (I don’t believe the organ waiting lists are any less weighted than the death squads who until the 1970s decided which kidney failure patients would get dialysis and which would get sent home with a fistful of morphine. And I still can’t shake my belief that it’s morally wrong for corporations to profit from the misfortune of the chronically ill.) It’s not a cure anyway; the cost of post-transplant anti-rejection medicine is astounding and growing every year. Plus studies indicate that pre-emptive transplants (transplants that occur when the kidney’s start to fail but before dialysis is necessary to survive) make more medical sense and in a couple of months I’ll be eight years into the dialysis experience.
This morning Sally Satel explores the concept of the “tyranny of the gift” with regard to kidney donors in the New York Times Magazine. Satel received a kidney last March from Virginia Postrel, the libertarian journalist/author.
I’m still trying to figure out if Satel’s piece clarifies or confounds my thinking on the issue. One thing’s clear: she’s traveled the same path but chose a different route.
Update: Wednesday, 19 December 2007 06:23PM CST
Nancy Green has the most level-headed and well-reasoned response to Satel’s essay I’ve yet found. nyceve at the Daily Kos tracks down Satel’s hypocrisy. Satel wrote in 2005, again in the New York Times, that a Kentucky inmate who offered to sell her a kidney for US$900,000 was “holding his kidney hostage.”
Dear Michael, it means a great deal to me that you like my post ‘Desperately Selling a Kidney’ I am a nurse and have worked with people who are on dialysis, self-dialysis, and post-transplant. You are very right that being a transplant recipient is no piece of cake, and I’m wondering what Sally Satel’s med list is, she makes it sound a lot simpler than what I’ve seen my patients go through.
I continue to be very impressed by Virginia Postrel’s donation, and I sincerely hope that both of them enjoy good health.
But no one knows what it’s like who hasn’t been there. I thank you for sharing your experience and knowledge. I never worked in nephrology, I do homecare for the elderly. I have had patients who accepted dialysis with forbearance, but I didn’t conclude from their stoicism that it was easy. I’ve seen people improve greatly after a kidney transplant. I’m not planning to die anytime soon, but when I do they can have anything I haven’t worn out.
I do think that the idea of using money, directly or indirectly, to entice people to take the risk and long term uncertainties of donating a kidney is immoral, and contrary to the medical ethic of ‘first do no harm’.
But I also think that in an imperfect world, if you find a way to help yourself without violating others you have a right to take it, and I hope that your doctors will find ways to protect your health and maintain your energy.
Check out kmareka.com for an intense discussion. a writer who identifies as Virginia Postrel’s partner has been leaving long libertarian posts in the comments to the article.
I’ve bookmarked your site because I meet people with renal failure pretty often, and it is good to read someone’s direct experience.
Happy Solstice to you and your family.