Five-Way Organ Swap
A reader sends this story along: Johns Hopkins has completed a 5-way kidney swap, in which five people gave their organs to unrelated people. But it wasn't pure altruism. It was a barter deal. In return for giving a kidney to an unrelated person, another donor gave a kidney to the first donor's loved one, and so on down the line five times. In other words, five persons reached a contract of sorts to donate a kidney to each others' family members so that their own loved one could receive a transplant.
Federal law prohibits, as it should, the buying and selling of organs. But this was, in its own way, a commercial transaction--with the consideration being an organ rather than legal tender. And the surgeries were apparently rushed so that no donor could change their mind about having a kidney removed once their family member received a transplant. Love can be a greater incentive than money, as we all know. Given that these donations can result in the debilitation or death of the living donor, I think we should be wary of such transactions.
HT: F. White
posted by Wesley J. Smith @ 1:22 PM
8 Comments
8 Comments:
I realize that every major opinion-making body from the Roman Catholic Church on down thinks vital organ donation is just ducky, yea, even heroic.
But does it ever occur to anyone else to wonder if we've moved, historically, too fast to embrace the practice? As with in vitro fertilization, it seem to me here that the consequences--the pressure on families to remove life support, the dubiously ethical economic and quasi-economic arrangements, the worries about whether death has been objectively ascertained, etc., etc.--of vital organ donation should perhaps make us rethink the entire thing.
I don't want to do away with vital organ donation from the actually dead. But I do enterain doubts about the advisability and propriety of live organ donation; and I know someone who did it! It was a true act of charity. I certainly oppose where this is heading, the harvesting of the cognitively devestated living, as we have discussed here before.
I can't read this without feeling that this is too much like blackmail. I don't like the way this is going.
Certainly the potential for being pressured and manipulated.
It's different, just because you _aren't_ donating to your relative, so for the actual donation you are doing, you don't have the same personal motivation. Hence the need to try to make it a contractual matter. Because you're only "virtually" giving to your own loved one, by a legal fiction. So they have to be very careful that you don't wait until your loved one gets the kidney and then renege on your offer to donate a kidney to a completely unrelated person to whom you have no personal loyalty. Not that I'm saying it would be right to back out like that. What I am saying is that the motive is different: It's something like, "I agreed contractually to give a kidney to X, whom I don't know from Adam, because by a convoluted series of such switches I can be a part of a causal nexus that delivers a kidney for Y, my dear child (or whatever). And if I don't carry out my end of the deal after Y gets his kidney, I may be sued for breach of contract."
Here's an analogy: Suppose that kidneys could be sold for money legally. And suppose that you aren't a match for your beloved daughter, who needs a kidney. But you are a match for a person who has the money to buy your kidney, and there is some other person who is a match for your beloved daughter but demands money. So what do you do? Of course, you sell your kidney to the man you match and use the money to buy a kidney from a matching donor for your daughter, right? So you are procuring a kidney for your daughter by donating yours, but indirectly, by using money as a means of exchange. That, in fact, is what money is for, so you don't have to barter unwieldy goods in a complicated fashion.
But I'm afraid the five-way swap is uncomfortably close to the sale-and-purchase scenario. But mostly everyone (myself included) recognizes that the sale and purchase scenario is unethical. So...
Jason, can you elaborate on, "The exchange is limited by the barter nature of it to altruistic reasons in a way that the cash swap is not"?
Is your point simply that in the case of a swap for cash I can spend the cash on all sorts of other things, not on a kidney for a loved one?
That's true, but don't you think that when we get to the point of involving ten people (if I've got this correct--five times two), we've ratcheted the barter up pretty far and made it resemble a cash swap somwhat by the very complicated nature of the case? At that point that it's sort of like selling your kidney for a "kidney voucher" or something--that you can use for a loved one if you want to--instead of for cash. "This voucher good for one matching kidney when one becomes available."
Would selling kidneys for kidney vouchers bother you less or more than the five-way swap?
Actually, the key to this whole transaction was the offer by a "wild card." One of the women had offered to donate after losing her daughter and husband. Her kidney was sort of the missing link or missing domino? - that set the whole thing in motion.
http://www.lifeethics.org/www.lifeethics.org/2006/11/more-on-illegal-5-way-kidney.html
I'm concerned about the stunt aspect of the 5-way, one day, transplant. Maybe the focus ensured better treatment for each of the patients. However,I prefer order and decorum, not publicity, when I practice medicine.
In situations such as this, where multiple donors and recipients are involved, all surgeries take place simultaneously in the same facility.
This involves an heroic effort on the part of the transplant staff. It ensures that no party reneges on their agreement to donate on behalf of their loved one.
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