Give Me Your Kidney

Yesterday, I published a post called Who Gets the Kidney, about a new television show (to be aired Friday) in the Netherlands. Several bloggers commented on it. Jules Crittenden wrote:

I stand in awe. I thought we ruled the world of stunningly bizarre, somewhat disturbing and tasteless schlock. They’ve pushed it out to the edge.

Ed Morrissey responded with a very thoughful, and personal post, one that should be read in full. His wife, Ed explains, “would not have survived long enough to get a cadaver donor in the present system” if they “had not found a donor” for her themselves. Ed explains that the system currently used (for donors) does not work, and people die because of it. In short, the system has to be fixed. Ed admits:

When we ration irrationally, we get irrational results. The BNN show tomorrow night is an example of this. Denied the ability to acquire a kidney through some rational method, these kidney-failure victims will abase themselves in public in order to save their lives. Denied a rational method of receiving compensation for her donation, the terminally ill woman will have to choose other, less objective means for rationing her kidneys. It sounds terrible, and it is, but you’d better believe that I would have jumped at the chance the first few months of this year to get one of those kidneys, had we not already found a donor.

I agree with Ed that there is a problem (to deny the existence of this problem would be ludicrous) but I have some issues with an overly enthusiastic approach (not that Ed is arguing in favor of such an overly enthusiastic approach):
- one, I am afraid that the TV show will accomplish nothing
- two, I wonder whether we should do everything to solve the problem? Literally everything? I would say no. There are limits. We have to save as many as people as possible, but not if doing so means that we downgrade ourselves so much that we consider matters of life and death to be entertainment
- three, why not make a documentary about a person who donates one of his or her organs (while still being alive) to help out a friend, family member or even a stranger?

4 Responses to “Give Me Your Kidney”

1. Give Me Your Kidney « Michael P.F. van der Galiën says:

   May 31, 2007 at 5:58 am

   [...] Cross posted at The Moderate Voice. [...]
2. Lynx says:

   May 31, 2007 at 7:19 am

   I’d like to say that by criticizing the show I am in no way trying to lay blame on the potential recipients of the kidney. This is a little like the opposing of the war, you can oppose the war and still support the troops. Likewise, the fact that this show is just about the worst in terms of taste I’ve ever heard of, I completely understand the patients who go. Living is not negotiable, if you need an organ and that’s the way to get it, as humiliating as it is, I totally understand. What is utterly shameful is that people in need of a kidney (or even a lung, or a piece of liver) are forced to debase themselves on television for the mere possibility of an organ.

   I don’t have a clue how organ transplants go in the US. In Spain we supposedly have a very good system, and surgeons with their facilities are available the minute they are needed, at least for transplant surgery. If the Netherlands has greater problems (which I would find surprising, but not impossible) they certainly need to fix them, but not like this.
   A sort of side note. When reality television started up, I thought “how boring, and how degraded” and this was still the Big Brother phase. Then Fear Factor came out, and I thought “geez, they really hit the bottom of the barrel”. Just recently in Spain “Cambio Radical” came out (apparently adapted from a British programme) which has women who dislike their own look undergo extensive plastic surgery to make themselves “better”. This made me sick to my stomach, and I thought “OK, there’s no WAY to get worse than this”. Now we have THIS programme (which, happily, Spanish networks have declined to broadcast) and I can’t help but wonder “what’s next?”

   - A show that has a contest of who slims down fastest?
   - A show where contestants must be the first to get pregnant by a man they don’t know?
   - A show where young people compete to see who can last the longest binge drinking before having to go to the hospital?
3. DLS says:

   May 31, 2007 at 3:41 pm

   As someone who has more interest than the typical person in the subject, I find the intrusion of schock and ethical problems into organ allocation to be disgusting — the subject is already an ocean-deep-and-wide source of ethical issues and concerns.

   Living is not negotiable, if you need an organ and that’s the way to get it

   Advertise, or go overseas and pay cash — and are you going to get an organ that’s genetically compatible, or even the correct blood type, necessarily?

   We’re cutting corners genetically as it is to try to speed up blacks on the US waiting list, we’re cutting corners with quality (expanded criteria donor organs), and some want to have the state pay donors, which is disturbing. The best thing to do at this point is to go to “presumed consent” for organ donation to reduce the supply problem, the core issue.

   The solution is more organs, not so much changes to the current allocation rules.

   At this time, the allocation of kidneys is subject to future changes, not only with a future full spectrum or scale or index range of quality rather than two classes, and likely to similar ratings for recipient candidates, but also already in the works are changes aimed at greater utility, as opposed to “fairness” (such as waiting time as a major criterion for allocation decision-making along with genetic compatibility).

   Already planned are allocation rule changes that seek to reach the maximum years and quality of life provided by the kidneys. There will be fewer standard (high-quality) organs available to older, sicker people under these changes.

   Here is what may be the best layperson’s writeup on this.

   http://online.wsj.com/public/article/SB117345431796732257-PGIlhWN9pkVmj0CFQP77RNr9bBg_20070320.html?mod=blogs

   Related:

   http://www.pkdcure.org/site/PageServer?pagename=medical07_unosmeeting

   http://www.bioethics.gov/background/ethics_of_organ_allocation.html

   http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/01/01/MNG3CNB93O1.DTL&type=health

   Here — some person decided, in today’s self-absorbed world, to do what? create a blog about transplantation and issues related to it such as allocation.

   http://transplantheadquarters.blogspot.com/2007/02/kidney-allocation-and-age.html

   http://transplantheadquarters.blogspot.com/2007/01/new-allocation-policies.html

   …

   Lynx: in France, I don’t know how long the show ran but the strangers-off-the-street sex-play-by-play-announcement show “Love At First Sight” or whatever it was, was already broadcast years ago.
4. DLS says:

   May 31, 2007 at 4:15 pm

   Michael van der Galien asked:

   [W]hy not make a documentary about a person who donates one of his or her organs (while still being alive) to help out a friend, family member or even a stranger?

   There already is literature available on living donation, which is heavily pushed by transplant centers and others in the transplantation community for a number of reasons. (Living donor organs often are superior; they often are from a relative and so have better genetic compatibility; one can do the transplant when one prefers rather than have to wait for an organ; it reduces the enormous need for cadaver donor organs.)

   http://www.kidney.org/transplantation/livingDonors/index.cfm

   http://www.livingdonorsonline.org/general.htm

   http://www.organtransplants.org/

   http://www.unos.org/living_donation.asp

   http://www.optn.org/about/donation/livingDonation.asp

   http://www.house.gov/mcdermott/kidneycaucus/livdon.html

   http://www.organdonor.gov/

   Please be aware that the issue is psychogically “powerful,” and is not always, guaranteed joyful and perfect. (A hint at how powerful is the practice of strict anonymity between donors and recipients of cadaver organs. An even better hint about living donation specifically is that a reason that an organ is not going to be donated — due to refusal, due to failed health tests for HIV or hepatitis, or due to genetic incompatibility — is often withheld from even family member recipients.)