A Right to Refuse?

A letter writer in The New York Times Ethicist column this week raises an interesting question: “Must I Donate a Kidney to My Awful Brother?” (Spoiler alert: I’m not going to tell you how the Ethicist answers.)

If you believe that blood is thicker than water in every case, then maybe the answer seems crystal clear, but I think it’s an intriguing ethical dilemma.

Background: Nearly 100,000 people in the United States are waiting–usually for several years–for a kidney from a deceased donor. Finding a living donor helps shorten that wait and saves lives. For me and for thousands of others, being a living kidney donor is a powerful, positive experience, but it’s a big deal.

First of all, before making a big decision like this, you should of course be well informed.

Then you need to consider all the personal issues. If you believe as I do that donating a bodily organ is an intensely personal decision (as much as I value living donation, I would never judge someone who has an open mind and chooses not to donate), it’s still difficult to land squarely on one side or the other of the question to the Ethicist.

Ultimately, anyone considering donating a kidney (or part of a liver) to anyone should carefully think about how they will feel about their decision whatever happens down the road–to the donor or the recipient.

In this particular case, for example, what if the brother continues to be a jerk to the donor? What if he doesn’t take proper care of the gifted kidney? What if the brothers never see each other again? The answers to these questions might or might not be a factor in your decision.

I remember interviewing a donor who admitted that she’d hesitated to donate her kidney to her brother with diabetes because he had long been irresponsible in caring for his condition and his general health. She went ahead with the donation anyway because she’d concluded that the decision felt right for her personally–whatever happened. She never regretted it. Interestingly, her brother turned out to be a very responsible steward of her kidney, but it was certainly wise of her to consider how she would feel if that were not the case.

I know of people who’ve donated to their ex-, other donors who later broke up with their girlfriend/recipient, people who lost touch with their recipient–and yes, even some donors who later developed health problems. In other words, not every donation situation is as straightforward as donating to a beloved spouse or son with a happy outcome like mine.

So do read the Ethicist exchange, and then think it over. Please let me know what you think.

For related posts, resources, and information on my new book, The Insider’s Guide to Living Kidney Donation, be sure to explore the rest of my website.