Flavia and Bill Walton were part of a very large kidney swap, involving 14 donor-recipient pairs.
“To see someone that you love most [in] the world deteriorate is a sense of helplessness and powerlessness that you just cannot comprehend unless you’ve been there. But to be able to do something is so empowering, but it is such a blessing,” says Flavia.
And good for them. These swaps are bringing healthy kidneys from living donors to patients. Kidneys from living donors are less likely to fail and tend to last twice as long as kidneys from deceased donors.
Kidney swaps bring donors to the table who in all likelihood would never have donated a kidney otherwise. Yet the expert in this article says that he worries swaps will push people on the list farther down and make them wait longer.
“We at least want to be fair with the people on the wait list who don’t have a family member available. Being fair might mean waiting a trivial extra amount of time, but we certainly don’t want to make those people wait years extra just because of the swap arrangements,” says Professor Robert Veatsch of the Kennedy Institute of Ethics at Georgetown University.
It doesn’t seem like there is an ethical issue here. If the donors in a chain donation are all friends and relatives of kidney patients, everyone gets a kidney from someone who was probably never going to be an altruistic donor for a stranger on the UNOS list.
And a lot of swaps start with an altruistic donor, who in theory, could have gone to the next person on the official list and donated there. But what happens in swaps that begin with a stranger is that a kidney at the other end of the chain does go to someone on the list.
Veatsch, whom I don’t mean to pick on, raises another very typical ethical concern about kidney donation, that compensation such as a tax break “taints altruism.”
I don’t feel tainted when I deduct my donation to a charity. How is a tax break for donating an organ any different?
It is important to think through the ethics of what we do, but our primary ethical obligation is to save lives and get out of the way of people who would like to do it. I am hoping that as we sort through these new ways to get an organ, that happens more and more.