It’s a HUGE ask. The hugest ask. Yet apparently people do it every year. quietly, without fanfare. True altruism. Maybe we should make a little more noise about it. Maybe we should recognize that while not everyone can—or should—say yes, those who do, deserve more recognition or something. Your suggestion of a generous tax credit is a fantastic idea!
As a fraternal twin myself, I can't imagine saying "no" to donating a kidney to my sister. I would just end up slowly drinking myself to death. FWIW, I found Dr. Satel's 2007 NYT article to be amazingly well thought out and even better written. Much of the long essay are like reading a novel.
Yes - a generous tax credit would be the way to go. Heck everybody else gets paid in this whole transplant rigamorole. The Tx workup clinics, the post Tx clinics, the surgeon, the anesthetist, ICU crew - why not the donator. I'm self employed - all the time off from my office would be a significant hit to my wallet.
Thanks Doc H....I like to think that when people turned me down I was gracious and understanding. But, as an outsider, I admit I was "angry" for Erica. She had the class not to complain about Linda, though I inferred that she was baffled and hurt. The pigs will save us, as you note. (As an aside, I have heard many stories -- and I had one too --of transplant coordinators dragging their feet in moving willing donoirs thorugh the system). I had one nurse-coordinator like that at NIH, but then two great ones since.
This is such a nuanced discussion and situation. Very interesting to consider all facets. It seems that the first order of consideration is that nobody anywhere, at anytime, should be expected to donate any organ! Thinking the woman's twin sister bizarre for declining seems a very "interesting" reaction. I would say, first order of business is not to expect that anyone SHOULD donate. I would hope that physicians, transplant coordinators, counselors - anyone involved in working with people with ESRD would coach that you cannot let anyone's response to this "ask" cause shock or anger. For a vast variety of reasons a person would not want to do this. To allow that response to affect a relationship (especially with a twin sister!) is not helpful.
I was comparing this, in my mind, to surrogacy. It is interesting that our country allows women to sell their eggs and to sell their uterus/entire body to help someone else have a child. Why is organ donation treated so differently? There are obviously a host of differences, but still an interesting comparison. Social mindset completely different. And I've not heard that people get angry at each other for not offering to be a surrogate. (and having children, for those that want to, is such a life-altering and life long thing - not just something "cosmetic" or "optional" or "elective")
I also don't think we need to compare "altruistic" acts. I consider myself to spend a lot of my personal time and life energy in helping others. But I've never considered getting on a kidney donor list. Effective Altruism is in itself a very interesting "movement" and not one I particularly admire. I don't think you will find more truly altruistic people within that movement than you will anywhere else.
I appreciate the thoughtful people working on this problem (often physicians or other medical people who have themselves received a kidney transplant, such as the author) - some of the creative approaches that have been brought up make a lot of sense. Certainly a situation that needs ongoing problem-solving. Hopefully kidneys can be "grown" in a lab someday. What a revolution that would be.
I agree with the Layperson. But to know for sure, we need pilots. Then again, it matters little to the kidnely patient who gave the organ as long as it was done willingly and donor's health was protected.
BRAVA Colleen Kelly!!!...and, yes, you do skip to the head of the list if you need a kidney.
As for pain, doctors need to be much more liberal with treating acute pain. The majority of patients don't even finish their opioid prescritions and they rarely become addicts unless they have a history of drug or alcohol abuse. And even then, it's not 100 percent risk
Donor here. Gave left kidney to an acquaintance in 2022. I wouldn't have considered it until I knew someone facing dialysis. He is an older gentleman, but couldn't imagine him spending all that time feeling shitty/hooked up to machines while I had a spare (we never fret about having just one of almost every other vital organ). I am a physician so was reassured by the data (long term health outcomes in donors same as non donors). I was worried my recipient would feel indebted to me (that "tyranny of the gift") but I do like to hear from him from time to time (just to see how he is doing). I have heard about some recipients ghosting their donors and that would have probably made me feel sad and used. Honestly, it was one of the greatest experiences of my life so far. I feel like a bad-ass. I had a few signs that I should do it (I believe in God and that I was led to this/called to it/reassured I was on the right path). I am annoyed that I cannot get disability insurance now (changed jobs a year after the surgery). One of the comments talked about pain management, and I will say they did a really bad job with that. I did not get opiates and was in agony a few times (but it's pain, it passes, not a deal breaker). I did mention it to the transplant surgeon at my follow up, but I get the pendulum swing after we addicted hundreds of thousands of people. I am O negative so "universal donor" but if I ever need a kidney (or other organ), I get bonus points (so I've been told), and that is a little insurance policy I guess, though I suspect something else will kill me someday.
Some hospitals in Canada will tell the recipient that a family member / friend is incompatible if they don't want to donate. This way if anyone volunteers because of pressure but doesn't want to, then the relationship doesn't get strained. "I would have done it, but histocompatibility... "
It’s a HUGE ask. The hugest ask. Yet apparently people do it every year. quietly, without fanfare. True altruism. Maybe we should make a little more noise about it. Maybe we should recognize that while not everyone can—or should—say yes, those who do, deserve more recognition or something. Your suggestion of a generous tax credit is a fantastic idea!
Thank you so much, Leslie!
As a fraternal twin myself, I can't imagine saying "no" to donating a kidney to my sister. I would just end up slowly drinking myself to death. FWIW, I found Dr. Satel's 2007 NYT article to be amazingly well thought out and even better written. Much of the long essay are like reading a novel.
exaclty right!
Yes - a generous tax credit would be the way to go. Heck everybody else gets paid in this whole transplant rigamorole. The Tx workup clinics, the post Tx clinics, the surgeon, the anesthetist, ICU crew - why not the donator. I'm self employed - all the time off from my office would be a significant hit to my wallet.
Thanks Doc H....I like to think that when people turned me down I was gracious and understanding. But, as an outsider, I admit I was "angry" for Erica. She had the class not to complain about Linda, though I inferred that she was baffled and hurt. The pigs will save us, as you note. (As an aside, I have heard many stories -- and I had one too --of transplant coordinators dragging their feet in moving willing donoirs thorugh the system). I had one nurse-coordinator like that at NIH, but then two great ones since.
This is such a nuanced discussion and situation. Very interesting to consider all facets. It seems that the first order of consideration is that nobody anywhere, at anytime, should be expected to donate any organ! Thinking the woman's twin sister bizarre for declining seems a very "interesting" reaction. I would say, first order of business is not to expect that anyone SHOULD donate. I would hope that physicians, transplant coordinators, counselors - anyone involved in working with people with ESRD would coach that you cannot let anyone's response to this "ask" cause shock or anger. For a vast variety of reasons a person would not want to do this. To allow that response to affect a relationship (especially with a twin sister!) is not helpful.
I was comparing this, in my mind, to surrogacy. It is interesting that our country allows women to sell their eggs and to sell their uterus/entire body to help someone else have a child. Why is organ donation treated so differently? There are obviously a host of differences, but still an interesting comparison. Social mindset completely different. And I've not heard that people get angry at each other for not offering to be a surrogate. (and having children, for those that want to, is such a life-altering and life long thing - not just something "cosmetic" or "optional" or "elective")
I also don't think we need to compare "altruistic" acts. I consider myself to spend a lot of my personal time and life energy in helping others. But I've never considered getting on a kidney donor list. Effective Altruism is in itself a very interesting "movement" and not one I particularly admire. I don't think you will find more truly altruistic people within that movement than you will anywhere else.
I appreciate the thoughtful people working on this problem (often physicians or other medical people who have themselves received a kidney transplant, such as the author) - some of the creative approaches that have been brought up make a lot of sense. Certainly a situation that needs ongoing problem-solving. Hopefully kidneys can be "grown" in a lab someday. What a revolution that would be.
I agree with the Layperson. But to know for sure, we need pilots. Then again, it matters little to the kidnely patient who gave the organ as long as it was done willingly and donor's health was protected.
Also, goes to show you how much alleged altruism really is coerced if doctors need to be giving out medical alibis in the first place.
Yes, it's called a medical alibi. One of the few noble lies in medicine that seem justified. Thanks, Amethyst
BRAVA Colleen Kelly!!!...and, yes, you do skip to the head of the list if you need a kidney.
As for pain, doctors need to be much more liberal with treating acute pain. The majority of patients don't even finish their opioid prescritions and they rarely become addicts unless they have a history of drug or alcohol abuse. And even then, it's not 100 percent risk
Donor here. Gave left kidney to an acquaintance in 2022. I wouldn't have considered it until I knew someone facing dialysis. He is an older gentleman, but couldn't imagine him spending all that time feeling shitty/hooked up to machines while I had a spare (we never fret about having just one of almost every other vital organ). I am a physician so was reassured by the data (long term health outcomes in donors same as non donors). I was worried my recipient would feel indebted to me (that "tyranny of the gift") but I do like to hear from him from time to time (just to see how he is doing). I have heard about some recipients ghosting their donors and that would have probably made me feel sad and used. Honestly, it was one of the greatest experiences of my life so far. I feel like a bad-ass. I had a few signs that I should do it (I believe in God and that I was led to this/called to it/reassured I was on the right path). I am annoyed that I cannot get disability insurance now (changed jobs a year after the surgery). One of the comments talked about pain management, and I will say they did a really bad job with that. I did not get opiates and was in agony a few times (but it's pain, it passes, not a deal breaker). I did mention it to the transplant surgeon at my follow up, but I get the pendulum swing after we addicted hundreds of thousands of people. I am O negative so "universal donor" but if I ever need a kidney (or other organ), I get bonus points (so I've been told), and that is a little insurance policy I guess, though I suspect something else will kill me someday.
Some hospitals in Canada will tell the recipient that a family member / friend is incompatible if they don't want to donate. This way if anyone volunteers because of pressure but doesn't want to, then the relationship doesn't get strained. "I would have done it, but histocompatibility... "
thank you!...if you have other articles handy, do send to my gmail, slsatel@gmail.com
Mouse heart beats again thanks to human stem cells | New Scientist https://share.google/KJWLbENRuvm1n4wDS
As an addictyion psychiatrist, I am not surprised. But thrilled you are doing well x 25 years!