ISO: Kidney Donor

Monday, December 17th, 2007
This post was written by Melanie Matthews

During this season of giving, Dr. Sally Satel offers a compelling account of her nearly two-year wait for a healthy kidney in the New York Times Magazine. The psychiatrist and lecturer at the Yale School of Medicine describes the actions of some potential donors who give, then take away, and offers some insights into donor psychology:

Donors can have their own agendas, too. The academic literature on donor psychology offers many examples, like a man who sought the adulation of his community by offering a kidney to his minister, a daughter who competed with her own mother to be the rescuer of another family member and a woman who told researchers that her motive for wanting to give a kidney to a stranger was to become “‘Daddy’s good girl.” Then there is the “black-sheep donor,” a wayward relative who shows up to offer an organ as an act of redemption, hoping to reposition himself in the family’s good graces. For others, donation is a sullen fulfillment of familial duty, a way to avoid the shame and guilt of allowing a relative to suffer needlessly and even die.

Dr. Satel also cites a review of published surveys on donor attitudes by Mary Amanda Dew, a psychologist as the University of Pittsburgh Medical Center, which found that about 95 percent of donors say they would do it again. Dr. Satel received a kidney from a “fond acquaintance” in March 2006, and today spends much of her time championing the need for healthy organ donation:

Theoretically, kidneys should be in booming supply. Virtually everyone has two, and healthy individuals can give one away and still lead perfectly normal lives. Yet people aren’t exactly lining up to give. At the beginning of 2005, when I put my name on the list, there were about 60,000 people ahead of me; by the end of that year, only 1 in 9 had received one from a relative, spouse or friend. Today, just under 74,000 people are waiting for kidneys.

She proposes incentives to spur donation among the living:

Altruism is a beautiful virtue, but it has fallen painfully short of its goal. We must be bold and experiment with offering prospective donors other incentives for giving, not necessarily payment but material reward of some kind — perhaps something as simple as offering donors lifelong Medicare coverage. Or maybe Congress should grant waivers so that states can implement their own creative ways of giving something to donors: tax credits, tuition vouchers or a contribution to a giver’s retirement account….In short, we should reward individuals who relinquish an organ to save a life because doing so would encourage others to do the same.

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