When It Comes to Kidney Donation, What Is Altruism?

What is altruism?

If I donate one of my kidneys to a stranger after reading about her health struggle in a newspaper, am I acting altruistically?

Or is my donation only an altruistic act if I allow doctors to decide whom to give my kidney to?

This question of what constitutes altruism, its parameters and its limits, nagged at me as I worked on this week’s story about Renewal, an ultra-Orthodox charity that specializes in live kidney donation.

The United Network for Organ Sharing, which tracks organ donations nationwide, only classes a live kidney donation as altruistic if a person gives their kidney blindly.

On the face of it, such a distinction makes sense. It is a truly selfless act to give your kidney to anyone.

By comparison, the donor who chooses their recipient is, in effect, saying that there are limits to their altruism.

They might not wish to donate their kidney to someone over a certain age (“I want my kidney to last longer”) or to someone who is obese (“I want my kidney to go to someone who looks after their body”) or to someone with a criminal record (“I want my kidney to go to a ‘good’ person”).

In the case of Renewal, most donors want to their recipient to be Jewish.

Some people might argue that’s not really altruistic.

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But can you honestly say that such a person has not performed an altruistic act?

Although the risks of live kidney donation are negligible, they do exist.

There is a 1-in-3,000 chance that the donor might die as a result of the operation.

There is also a small risk that they might develop diabetes and high blood pressure that could damage their remaining kidney. (Such health risks are outweighed slightly by the fact that live kidney donors get priority if they need a kidney in future.)

Kidney donation also takes time. Before the operation, you have to go for a battery of rigorous tests to make sure you are mentally and physically capable of donating. The post-operative recovery takes weeks.

Donors are also giving up an organ that they might need to donate to their own family and friends in future.

Despite all of the above, they are submitting themselves to surgery to save the life of someone they have never met.

Maybe that doesn’t constitute an altruistic act as far as UNOS is concerned. But as far as I am concerned, it should.

Contact Paul Berger at berger@forward.com or on Twitter @pdberger

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When It Comes to Kidney Donation, What Is Altruism?

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