Advocacy Ethical Considerations Living Kidney Donor

Now is when I start receiving hate mail….

I’ve been compiling notes and thoughts on an analysis of websites that allow people in need of an organ to publicly solicit for a living donor. It’s a combustible topic in the transplant community these days, especially in light of a published research study outlining their ‘ethical problems’. My grand opus on the topic will have to wait, because I want to be factual as opposed to persuasive, but today’s topic is a perfect example of why the issue of public donor solicitation is such a hotbed of controversy.

I have a ‘google alert’ that delivers me a daily email with synopses and links to new articles, webpages and blog posts related to living donors. Every day for at least a week, my report has contained some mention of a girl in need of a kidney – the SAME girl.

(Pardon me while I try to be as generic as possible, both to protect the people in this situation and to save me from a small percentage of the nasty o’grams I’m guaranteed to receive.)

The original post was on the mother’s blog, pleading for people to come forward and be tested as a potential donor, because the girl will only match 1 in 50 people. Totally understandable; most people will do whatever is within their capacity to save someone they love. However, this dang story has shown up every day on some other well-intentioned but obviously soft-hearted and ignorant* person’s blog, and I am truly annoyed.

I don’t fault the girl’s mother, for the above stated reasons, but the people around the ‘net that have glommed on to this girl’s plight really need a reality check. Her story is a sad one, no doubt, and it pulls at the proverbial heart strings. On that level I understand why folks are drawn to it (and her), and why they’re sharing it. However, and this is where the ‘ignorance’ comes in, she is not alone.

This girl is not the only person of her age on the waiting list. In fact, she is probably not the only girl of her age with her underlying challenges and disorders on the waiting list. What this girl has, however, is a mother with health insurance (check), a computer (check, check), internet access (check again), and the technological savvy to post a blog and spin a heart-wrenching tale of her daughter’s plight (check, check, checkity-check).

These bloggers, and the blogs’ readerships, need to consider a couple of simple concepts:

1. Each of these tissue-matching tests cost money. Insurance companies take premiums from consumers, so ultimately, it’s those same customers who are footing the bill for all this lab work. The girl’s mother was pissed at the hospital because they wanted to limit who and how many people were tested at one time. She resented them for being fiscally responsible and also recognizing that a technician and a lab have finite resources. If they are consumed with her daughter, they are neglecting everyone else. Her daughter is extremely fortunate to have a mother who is unconcerned about such things.

2. Tissue matching is first by blood type, because not every blood type can donate or receive from every other blood type, and second by antigens, otherwise known as HLA. While everyone has six HLA, there are a hundred subsets of each. If, hypothetically, 50 people are tested to find this girl’s donor, that leaves 49 tissue-catalogued people with kidneys to spare. At least some of them would match one of the 75,000 plus people on the national waiting list.

Somehow, and this is my giant aggravation, none of those kidneys will find themselves into the bodies of anyone aside from the girl in question. The cost of the tissue testing will be wasted and potentially, so will someone’s life because some will die before another kidney becomes available. It’ll hapen because it’s not really the act of donating a organ that motivates these people, it’s doing something for this girl.

If asked, they’ll say they’re not judging this girl’s life to be more worthy than any other. They’ll say the other 75,000 people deserve a kidney – but just not theirs.

I say, Judge not lest ye be judged. You just might be found lacking.


*’Ignorant’ should get me a negative comment or two, but I use it in the true definition of the word – unaware, uninformed, a lack of knowledge or information.

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