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A Student Questions

Aha! Robert. Some of your questions are what they call "leading" questions in legal circles, meaning that you appear to have your mind already made up and you are looking for confirmation from me. I may well agree with some of your conclusions, but I'll try to make general comments with regard to my position rather than giving straight yes and no type answers to your questions. I hope you will be able to get some benefit from this all the same, and that you do well with your paper.

Obviously, our kidneys do not belong to the government. They belong to us personally. However, the government often has to pass legislation which restricts us with regard to what we can do with our bodies. The reasons that the government gives for not allowing people like ourselves to give a kidney to someone else would be the same reasons for why they would at least want to REGULATE such transactions even if legislation were changed to allow us to give our kidneys freely. I'll try to explain them. Remember, this is something coming from someone who wants to see the legislation loosened... but it helps to understand how there could be problems if there were no legislation at all.

First, there is the ethical concern that some doctors have, about taking a perfectly healthy person and cutting a major organ out of that person's body. Some doctors feel that it would be on their conscience if that person were to die as a result of such an operation (and it can happen). They make a promise (called the Hippocratic Oath) when they start medicine, that they will not use their skills to do anything that would take away from the health of another person. Even when a kidney donor does not die, there are infections and other complications that come up fairly often with such major surgery. The donor ends up marginally worse off than they were before the operation.

Of course, our position is that such doctors are not looking at the bigger picture. In a skin graft, for example, they take perfectly good skin away from one part of the body, and graft it onto another part that is urgently in need of new skin. The damage to one part of the body is offset by the benefit to another. In fact, with virtually all surgery there is damage to healthy parts of the body to get to the parts that are in need of correction. With a transplant, we just ask that the cost/benefit factor be expanded to include more than one person, i.e. the damage to the donor's body must be weighed up against the benefit to the recipient. And on that basis it all starts making sense.

However, a better argument for legislation that restricts donations is that the government actually wants to protect the rights of the donor. In other words, it has nothing to do with saying that the donor does not have a right to do what he/she wants with his/her own kidney, but quite the opposite. It has to do with OTHER PEOPLE not having the right to coerce someone into parting with a kidney that he/she may not REALLY want to part with.

In our experience we have already found that some hospitals make it sound much easier to donate a kidney than what it really is. In other words, they may be trying to hide the risks, because they do not want to frighten people away from donating. (The hospitals make big money through such operations.) I'm not saying that they are lying, but just that they have a tradition of trying to reassure people that "everything is under control", and so they may reassure donors a bit too much as well.

Legislation requires that donors be given a chance to consider all of the worst possible scenarios, including such things as dying on the operating table, or giving a kidney that does not "take" with the recipient. We are dealing with a family in Israel at the moment, where a woman's daughter donated a kidney, but the surgeon cut one artery too short, and they had to throw the kidney out, because it could not be hooked up to the mother's artery when they tried to install it into the mother's body a few minutes after taking it from the daughter. Imagine how the daughter must have felt.

Hospitals, too, have regulations, because they do not want to be sued by donors later, if the donors change their minds after making the donation, and if they argue that they were not clearly informed of all the risks. One of our members had had a vasectomy (an operation to stop him and his wife from having babies), but he was never asked whether he had had a vasectomy by the hospital before the operation. It turns out that an artery is cut during a transplant that normally goes on from the kidneys to the testicles. Normally the testicles can manage okay with the blood coming in from a different artery... UNLESS you've had a vasectomy, in which that other artery has been cut as well. With both arteries cut, the testicle can die a very slow painful death. We will not sue the hospital, and as it turns out, the testicle seems to be getting by on blood flow from some smaller blood vessels at the moment, but this is the kind of thing that legislation can help to prevent, by restricting hospitals from performing such operations until they have first gone over all of the issues.

Then there are people like myself that the legislation is aimed at protecting people from! You must have been able to pick up from the Guardian article that Jon Ronson was trying very hard to depict me as a mind-control manipulator who was secretly coercing the members of our community (the Jesus Christians) into donating kidneys so that I could get some kind of publicity for myself out of it. Obviously, I strongly disagree with that. But I also realise that it is the sort of thing that could happen and the sort of thing that people would suspect. And so there need to be things like psychological tests, to determine whether the person is donating because he/she is fully convinced personally about what he/she is doing.

We have lived for some time in India, where poor village people regularly sell their kidneys to hospitals for transplants. On the whole, I think it is a good idea. The village people receive enough money that they can greatly improve their lifestyle. Some have been known to use the money received from donating a kidney to pay for a life-saving operation for themselves or a relative suffering from some other ailment. Additionally, people dying from kidney diseases get the kidneys that they need. If people were allowed to buy and sell kidneys all over the world, there would be no shortage of kidneys for anyone in the world who needs them (providing they or their insurance companies have the money to pay for the operation plus the cost, to the recipient, of the replacement kidney). There are hundreds of thousands of people in the Third World who would LOVE to sell their kidneys for the kind of prices that are presently being offered on the black market (something like $US10,000 plus all expenses). If sales were regulated, the donors could get even better treatment, and probably even higher prices could be set for them.

BUT... and this is a very big but. When they checked out villages where kidneys were being sold in India, it was learned that almost all of the donors were wives... wives who had been pushed into being the donors, so that the husbands could get the money. It may be that some couples discussed it and felt that the husband, who was involved in heavy physical work, needed two kidneys more than the wives; but my suspicions are that the husbands were just exploiting their wives. That is an example of the sort of thing that governments and hospitals do not want to encourage or to be a part of. Can you see how there must be some kind of legislation to control that sort of thing?

Of course, just outlawing unrelated kidney donations altogether is not a very good solution. Thousands of people are dying needlessly because of that. It is our opinion that the regulatory bodies are often more inclined to stick their heads in the sand and ignore the urgency of the situation... because it's not their life that is in danger.

Although we feel that it is not wrong for people to sell kidneys (After all, everyone else is benefitting from the operations, so why not compensate the person who is losing the most in order for it to take place?) we believe that things may have to be changed one step at a time, and the first step is to allow people like ourselves to donate freely. Investigations could be made to ensure that money is not being paid secretly, but once it is established (at least as far as that is possible) that the donation is made freely, then it is probably unlikely that someone has been coerced into giving. Most corruption comes because someone is trying to make easy money (e.g. the husbands who profit at the expense of their wives in India).

Once Jon Ronson determined that our community was not making any money for the donations that we are making, it was much harder for him to paint me as the baddie who was profiting from donations made by members of our community. That is why he had to create the publicity angle, i.e. that I was obsessed with publicity, and that I had pushed people into donating just so that I could get publicity. (He also invented the story about me wanting bad publicity from him in order to get myself banned from donating personally. He pretended to be concerned about how that would affect the person I hope to donate to, and yet he went ahead with his story, including the negative angle, showing that HE was the one who didn't really care about sabotaging our efforts in order to make money from a good story!)

Of course, for us as Christians, the motive is extremely important; and that is why we see a significant difference between selling a kidney and giving it away. We do not think that it is WRONG to sell a kidney (providing a person is doing it of their own free will, and providing they have a clear understanding of the risks), but when that happens, it clouds the issues over whether love has anything to do with it. We prefer to be clear about the fact that we are giving for love and for God. As you put it, yes, we ARE hoping for a reward of some kind from God. Of course, Jesus also said that if we get praise and recognition from others for what we do to help the needy, then that becomes our reward, and there is no need for God to reward us in heaven. Well, we've gotten a fair bit of praise (and a bit of condemnation as well), so we probably don't have much reward coming from God either. Nevertheless, there is a great deal of personal satisfaction from knowing that we have saved someone's life (or even from knowing that we TRIED to save someone's life... in the event that it doesn't work.)

One other thing that has not come out so far in the media coverage that we have received. In the U.S., where unrelated live donors are becoming widely accepted, there is an understanding that a donor who should ever need a kidney themselves automatically goes to the top of the priority list. In other words, there is actually a tangible personal BENEFIT to a live kidney donor that helps to offset the argument that you should keep both kidneys "just in case" you should ever need a spare yourself. And once people get over the initial hesitancy about live donations, one should not have to feel obligated to hang onto an extra kidney in case a relative should ever need one, because there will be so many of us giving that a relative would never need fear being without a donor. It's just that someone has to start the process going, and we are trying to contribute to that movement.

You asked: What does human integrity mean to you?

That's a very good question... although I'm not sure how you are relating it to the subject of donating kidneys. Integrity is something that we teach strongly amongst members of our community. It means doing the right thing, even when it is costly to us personally. Another similar word that doesn't seem to be used much these days is "character". I guess it is because of our understanding of character or integrity that we think it is "only reasonable" that people would offer a kidney to someone who is dying, if it could save that person's life. And it should not matter whether or not we are related to that person.

You asked: Would you consider donating your sperm to an infertile couple? If so why? If not why not?

Errr... wellll... not sure. It's a very different situation. First, it's very easy... hardly costs anything to do, and so I should think that there are heaps of others who could (and perhaps would) do it just as easily as I could. Of course if I had some rare gene (for example) which would make my sperm especially helpful, then that would probably make me more willing to help them out in that little way.

However, the most important difference here is that there is no life in danger. I would be helping to MAKE a life (in a world that is already fairly overcrowded), but I would not be SAVING a life, as would be the case with donating a kidney. So I don't feel an urgency about such a thing.

Well, hope it goes well for you, Robert. Good luck with your exam. (I'd love to see what you come up with!)


Dave McKay, for Jesus Christians

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