Women die in childbirth too but no one calls for an end to pregnancy
For those that think living donation is unethical because of the risks, then they must think pregnancy and childbirth is unethical too.
Let me begin by stating the obvious: reproduction is a biological function. All living creatures do it in one way or another. Last time I checked, no other life form aside from human beings swap organs.
2. Pregnancy and childbirth is done by one person – the mother. Sure, we’ve created midwifes and other medical personnel to increase the safety of the mother and baby, and head-off any complications, but for millenia women squatted in fields or caves and pushed out Junior, thereby perpetuating humanity. If intevention was required for reproduction, our planet would be nothing but a lifeless husk. Instead, we’re rife with flora, fauna, animal, vegetable, bacterium, etc.
Living donors, on the other hand, do not remove their own kidney (liver, etc.); an entire surgical team is required, with specialized knowledge, tools and resources. If all hospitals and medical personnel refused to perform living donations, the practice would stop. Conversely, if the same were true of pregnancy and childbirth, babies would still keep popping up in the world.
3. Because pregnancy and childbirth have occurred since the dawn of time, humanity has amassed a wealth of knowledge on the subject. Can the same be said of living donors and living donation? No. Living donation has only existed for fifty years. In addition, no one in the medical community has bothered to track, follow or study living donors in any sort of comprehensive manner.
4. The public is aware that some women die or experience major complications during pregnancy and childbirth. A simple web search will bring up myriad websites, and a trip to amazon.com will fill an entire bookshelf with tomes regarding the matter. In fact, I received an email from credo.com the other day about the “Global MOMS Act” that will expand access to quality maternal health services. The risks and pitfalls of pregnancy and childbirth have been discussed, written about and are supported by society at large.
This is the complete and total opposite of the living donor experience. Until 2006, no agency had any sort of purview over living donation at all, and since then, UNOS/OPTN policies have been lax and ‘voluntary’. As one of my recent blog posts stated, transplant centers are only required to submit follow-up forms for living donors at the six-month, one-year and two-year mark (not that they, personally, are required to see the living donors. No, they can simply mail the form to the living donor and it is up to her/him to see their primary care physician, complete the physical and ensure the form is submitted). Yet MULTIPLE transplant centers have reported ALL of their LDs ‘lost to follow-up’, even though the mandate stipulates a 95% compliance rate.
In addition, even if one accepts the transplant industry’s stated mortality figures, one or two living donors will die every year as a direct result of the procedure – within 90 days of surgery – yet this information is kept quiet; covered up by the hospitals and UNOS/OPTN and hidden from the public. Living donor deaths after the 90 day post-op period are automatically reported as not being as a result of the nephrectomy or life with one kidney. Since the transplant industry denies any long-term risks of living donation, it’s easy for them to call the deaths ‘unrelated’.
5. In the vast majority of cases, pregnancy and childbirth does not leave a woman at lifetime risk for greater health issues. Unless something goes terribly awry, women are able to assume the same quality of life post-childbirth/pregnancy as before.
Living donors however, assume higher risks for cardiac disease, hypertension and kidney failure, which they’re usually not informed of prior to the surgery (see Housawi 2007). While long-term studies have not been done on living donors, much research has been conducted on those with suppressed kidney function and those who’ve had a kidney removed out of necessity.
While most LDs, as well as transplant professionals, would like to perpetrate the myth that ‘one kidney is enough’, the post-donation GFR of kidney donors puts LDs in the beginning stages of kidney disease and categorizes us as having reduced renal function. Bad PR or not, LDs have assumed the same complications and warnings as those diagnosed with chronic kidney disease.
We are not the ‘general population’; post-pregnancy or post-childbirth women are.