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When Altruism Isn't Enough: The Case for Compensating Kidney Donors Paperback – January 16, 2009
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Arthur J. Matas then discusses the risks to kidney donors, which turn out to be minimal. As a reasonable person, this would be my largest concern. But it turns out that most healthy people have plenty of kidney capacity with one and those who have donated over the decades have not hard significantly increased adverse outcomes.
Huang, Thankur, and Meltzer then tackle the cost effectiveness of renal transplants by comparing it to no treatment, hemodialysis, and what this might mean to the valuation of a kidney. Julio J. Elias provides a framework for a compensation system. This is obviously more for providing something reasonable to discuss than as a final proposal.
James Stacey Taylor and Mary C. Simmerling deal with the reasonable objections:
-Will a legal market create a black market?
-People will be coerced into donating.
-People will fake their eligibility for donation to get money.
-The poor will be exploited to save the wealthy.
-Because of subsequent health problems, donors will be actually be worse off.
-Compensation will actually lead to fewer organs becoming availability.
Satel comes back with a chapter dealing with the issues of human dignity, the way money taints donation, and the romaticization of altruism.Read more ›
As the book notes, the issue for kidney transplants is this: If everyone in the United States donated his/her organs at death, it wouldn't make all that much difference for people waiting for a kidney transplant, because less than 1 percent of all deaths yield usable kidneys. So organ donor cards are important, but not for kidney transplants. Living donors are key to saving lives.
The book explores the economics of kidney transplants, and how expensive dialysis is, compared with transplant, even if we included donor compensation. It also offers two models for compensating living donors. One is a government incentive, and the other is a little more free market. Both seem workable, if properly regulated. All the screening for whether someone was physically and mentally fit to donate would remain in place.
Look, about 100 people like me come forward in the U.S. each year to donate a kidney to a stranger. I'd love to think we could get that number up to where it would need to be to retire "the list," but it's unlikely. Is paying donors unethical? No. Letting kidney patients die when there is a way to get them a needed organ is unethical.
This quote from the book's editor, Dr. Sally Satel, hits the nail on the head: "... the critics [of donor compensation] have a far greater allegiance to abstract ideas about dignity and the visceral wisdom of queasiness than to actions that could avert needless misery.Read more ›
Most Recent Customer Reviews
Just like a systems-thinker,Dr.Satel has the dexterity to scratch the surface to show us what lurks beneath. Read morePublished 15 months ago by Arjun Verma
I came looking for honest debate on the issue and I left feeling cheated. There is nothing new presented, just the same old unproven theory that the authors' good intentions will... Read morePublished on July 29, 2009 by T. A. Falsey