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Wednesday, December 5, 2012

Michael has a renal disease. Can the doctor save his kidney with cash?


Title Picture.
Michael (names changed) doing dialysis. Credit: Flickr.com, Jimforest.
Michael (original name withheld) has a renal disease. The doctors say he would not live long without a kidney transplant. He has been surviving for long on dialysis. “You have to wait for longer time,” the doctors told him, because there is a shortage of available kidneys for people like him who need transplant. He has been waiting for a long time now and his parents and friends are getting worried. “We hope to find a compatible kidney from a deceased donor, although having a living donor donate you his kidney is not impossible.”

“Can we pay for someone to donate a kidney?”

“Why?”

I heard it is possible,“ his father tells the doctor.

His father is ready to pay for the funeral expenses of any deceased donor. He is ready to help the child of anyone alive who would donate a kidney to Michael. He was ready to save the life of his son for anything.

The doctor is shy of accepting a black market for kidneys. The World Health Organization, (WHO), has acknowledged it though that one in every five kidneys transplanted per year comes from the black market.

The black market is an unethical alternative for a kidney.

The doctor consults his colleagues in Canada. A released Canadian study revealed that Canadians are not averse to financial incentives for kidney donations from a living or deceased donor. He was also referred to a 2010 University of Pennsylvania health study that found that if offered financial incentives for kidney donation while alive, most persons might not be influenced to risk their health for money, and that it would not crowd out the market for generous, altruistic kidney donations.

The doctor is skeptical about the University of Pennsylvania’s conclusions. He knows that a booming black market that exists in Asia and South Africa was pointing to the contrary, especially for the poor. He could remember the widely reported news that Serbians summarily executed their prisoners, selling their kidneys to waiting transplant surgeons for monetary benefits. The doctor is conscious that Michael has been waiting, like many others, for a kidney. He did not want Michael to die, but his conscience was disturbed applying for a kidney from black market sources. He did not understand the logic behind why a doctor should allow the use of kidneys from donors with risk factors for harboring transmittable infections. The strained supply did make some push ethics aside.

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In the evening he was supposed to check on Michael’s condition. How he envied this young man! He had struggled through medical school on loans! What Michael’s parents had spent on dialysis was staggering.

After every option is considered, a life is more important than money.

“I wish one of your relatives, or friends, had a compatible kidney. It would solve this brouhaha.”

Michael only sighed. The wait would have to continue.

“We are looking out for every avenue to save your life. Don’t worry, your wait will soon be over,” the doctor promised.

“We are considering doing what your father asked for. When we find someone that is ready to give his kidney so that we can pay his family to take care of themselves after that, your wait will be over. Just one of my options.”

“I hope it will not discomfort the family? I do not want to be seen as a heartless person.”

“It is better than having to go to the market to buy a kidney, any kidney. “

Michael sighed.

“It is illegal?”

“But not in Iran. Donors get about $2,000 to $4,000 for a kidney. They have literally eliminated the waiting list there. What I have not heard is how much of human body parts is being sold on the open market. Where money is involved, people do all sorts of deceptive things to get it, to the extent of making others slaves.”

He looks Michael straight in the eye. Michael did not flinch.

“There is so much poverty in the world, you know,” Michael said. He understood the doctor’s concerns like one does understand the difference between sunset and sunrise.

The doctor lowered his head. He thought Michael could read his mind.

“People have ways of making the impossible possible. What about these poor people? Some end up sick afterwards without realizing what they have put their signature to.”

“I understand.”

“I have applied for a kidney for you; from the black market.”

“I have absolute trust in you, doctor.”

He sighed. A big weight was off his shoulders.

“We will check and double check for every sort of disease, hepatitis and HIV. It is unfortunate, unless you have to wait longer. I did it to save your life, Michael.”

“Whatever you say, doc.”

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