I donated my kidney. And I have to say that, with the exception of my marriage and the birth of my children, living donation was by far the most meaningful experience of my life. The only reason I write anonymously here is that I never wanted to broadcast what I did. The act was rewarding enough.
Each of the dozens of donors I have met has found the experience to be life affirming and life altering. Whatever else we have done or will do, we have extended the life of another person and joined our life with that person.
The experience was so fulfilling in itself that I have to take objection to the Forward’s recent editorial, “How To Make Kidney Donors Whole,” which argued that society should do more to compensate and help those willing to become donors. I felt that it vastly overstated the financial challenges facing living kidney donors and proposed a flawed solution with dangerous legal and social consequences.
It is true that living donors incur some expenses beyond the medical costs associated with the surgery itself, which should be fully covered by the recipient’s insurance. Manual workers need to take off four to six weeks post-surgery, and office workers two to three weeks. The testing process also involves several visits to a hospital before and after the donation, and post-surgery, donors need to be more vigilant about annual physicals and lab testing. However, these expenses and inconveniences, while not trivial, are no more onerous than other routine surgeries such as hernia repairs and appendectomies. And many faith-based charities, such as Renewal — also profiled recently in the pages of the Forward — provide resources for donors who lack the means to absorb these costs.
But far more significantly there is no real evidence that the lack of compensation has been a deterrent to living donations. In the years since I became a living donor, I have followed these issues closely. I recently participated in the Transplant Games of America, where I spent time with dozens of living donors. Every donor I met, most of whom were of modest means, reported that the donation experience was among the most meaningful in their lives. We donors are already whole; monetary and in-kind compensation would only cheapen and trivialize an incredibly moving experience.
The Forward’s premise that compensation for lost time and other expenses would encourage more living donations and save lives could set our country on a dangerous path. Compensation of donors, however well meaning, is suspect both legally and ethically.
The National Organ Transplant Act, which mirrors laws in most countries, explicitly prohibits the type of monetary transaction the Forward advocates. This prohibition has strong public policy roots in preventing exploitation and in ensuring some degree of fairness in organ allocation.
The first chapter in Pirkei Avot teaches us to create a fence around the Torah. The federal ban on compensation of living donors is such a fence. Once we permit some compensation of donors, we can unwittingly progress to a system that favors wealthy recipients and exploits potential donors.
I know that it is heartbreaking to see members of our community suffer and often times succumb to kidney disease when anyone could potentially step forward and dramatically add to the length and quality of their lives. But altruistic donors make up a very small number of those who donate. The vast majority of living donors are siblings, children or parents, and spouses. A small percentage of them are friends and distant relatives. In a world of compensated donors, these loving relatives and friends might very well stand back and permit a poorer person to bear the burden of donation, reasoning that the person would be paid for the trouble.
The Jewish community has sustained significant black eyes over the years due to the perception that Jews were not adequately participating in the donation of organs from our deceased relatives. In recent years, mainstream media outlets have reported that Israelis were taking part as surgeons, recipients and brokers in illegal and exploitative transplant tourism in Turkey, Kosovo and Costa Rica. The Forward’s suggestion of the possibility of compensation can easily become part of the narrative of the Jewish community shirking its obligations. Do we want to repeat the tremendous embarrassment all Jews must have felt in reading, in The New York Times last summer, a quote from an Israeli bioethicist that Israelis “don’t see why people should risk their lives if there is somebody in Ecuador willing to sell them a kidney”?
Groups like Renewal do wonderful work and have certainly saved lives while encouraging and celebrating a most wonderful mitzvah. The Jewish community has made tremendous strides in taking responsibility for increasing deceased and living organ donation. I am proud to be among the hundreds of Jews who have stopped forward to become living donors. The Forward’s editorial, however well intentioned, threatens this progress and plays into the hands of those with suspect economic and social agendas.