Sunday, August 2, 2009

Larissa MacFarquhar on Kidney Donations

Larissa MacFarquhar has an extremely interesting article in the July 27 New Yorker about the private kidney donation industry.

MacFarquhar personalizes the issue with the story of Paul Wagner ("he believed that if his needs were met and he found himself in possession of a surplus - of money or time or wherewithal - he was obliged to share it") donating one of his kidneys to Gail Tomas (a "vivacious, chatty, candidly emotional" retired opera singer who had been unable to find a donor through regular channels and then signed up on MatchingDonors.com.)

MacFarquhar raises all sorts of fascinating questions about how we conceive of "giving" of ourselves and why most people are instinctively confounded by the idea of freely donating an organ to a stranger:
"Most people find it uncomplicatedly admirable when a person risks his life to rescue a stranger from fire or drowning. What, then, is it about saving a stranger by giving a kidney, a far lesser risk, that people find so odd?

Do they feel there is something aggressive about the act, as though the donor were implicitly rebuking them for not doing it, too? Or perhaps it's that organ donation, like rescue, is conceived in cold blood, and cold-blooded altruism seems nearly as sinister as cold-blooded malevolence."
The article reports that 7,000 donors have signed up on MatchingDonors.com, and about 600 have actually gone through with the surgery.

One of the most interesting issues is the push-back from the "kidney donor establishment" against the private donations that are facilitated by MatchingDonors.

Bob Hickey, the first donee patient to list himself on the website, suspects that "the United Network for Organ Sharing, the nonprofit company to which the government contracts out the management of the cadaver-organ waiting list, intimidates transplant centers into rejecting Internet donors ... indeed, UNOS takes the position that MatchingDonors.com 'exploits vulnerable populations and undermines public trust in the equitable allocation of organs.'"

This piece is so interesting. I don't think I've ever read anything in-depth about organ donation. There are so many complex moral questions involved. Reading articles like this reinforces in me the tremendous power of the written word to expand one's worldview by introducing otherwise completely unknown/un-thought-of issues and challenges.