There’s some things money can’t buy. We don’t like the idea of treating parts of the body as commodities. As beautiful a sentiment as altruism is, it just isn’t enough. People have two kidneys situated on the back, behind the ribcage, they look more or less like a bean. And kidneys are organs that filter waste material from the blood and process that into urine. They’re extremely important, because if your kidneys are failing, you’re collecting quite a bit of waste material which is detrimental for all other organ systems. A typical dialysis patient has a poorer life expectancy than many cancers. After decades of experimenting, in 1954 was the first successful human transplant, which revolutionised the field. My daughter was involved in a car accident. It was clear that her injuries weren’t survivable. But Fi had let us know that, if anything had happened, she would want to give her organs. So when we arrived at the hospital and were given that devastating news, this felt like something that we could all get behind and for something positive to come out of such a sad time. I mean what an incredible legacy. Fi saved four people’s lives on that day. In 2006 I went for a regular check-up and I felt fine, but the blood work that I got showed that my kidneys were in very, very bad shape. I had to either go on dialysis, hooked up to a machine for three to four hours a day, about three times a week, or I would have to try to find a donor. Lots of people still don’t know that many people could actually donate a kidney. Removing one kidney should not affect someone’s lifespan. And also should not affect someone’s life quality. A kidney from a living donor in general will have a much better quality because it comes from a healthy and tested person. Kidneys are expected to survive up to twice as long on average in the recipient. I was lucky, I had two people who were willing to sacrifice a body part to me. It leaves you speechless with gratitude, but it also leaves you speechless with sorrow and anger that there are so many people who don’t have friends or relatives who can give them a kidney and who die waiting for one to become available. So that’s how I became very interested in our organ transplant system and how we should change it. No-one needs two kidneys, and there are many desperate people who need one. If they were compensated their lives could be improved at little cost to their health, while saving the life of someone else. The idea is to offer people an in-kind benefit, not cash, but maybe loan forgiveness, or a tuition voucher, or a contribution to their retirement account in exchange for a kidney. If I were a patient with failing kidneys, and I faced a short and miserable life, and I had the opportunity to buy a kidney, and was assured that the donor was being properly compensated, you bet I’d take that option. Currently it’s not allowed to donate a kidney under any form of payment. We rely on the goodwill of people to help others. It’s not the wealthy who would be wanting to sell their organs, it’s people who are on the poverty line, in very desperate situations. And those people are also the most vulnerable people in terms of poor health in later life. Incentivising people to donate more is actually a way to starve black markets, it’s not to recreate them, it’s to undermine them. If you reward a person amply for the sacrifice they’ve made, something they go into with their eyes open and well informed, that’s not exploitation. No-one really knows what will happen if you start doing this. Because even though personally I’m not necessarily fully against it, if it would drive people to donate, but the effect could be that it all becomes a business transaction. And that the more obvious donors may not donate because they will tell the recipient, “Oh, you can go and buy a kidney, right?” It might actually reduce the number of people that want to donate, because they don’t want to be involved in such a scheme. All of a sudden, transplantation becomes… a thing that you can organise as long as you can pay for it. People are dreaming to build kidneys in the laboratory, bio-printed or 3D-printed organ structures, modified pig organs, so that’s a revolution. This is the only way to solve the problem. It’s so much needless death. It feels like an incredible gift, and I don’t know how that gift can be quantified. When we’re considering this policy option, most of us don’t weigh the pros and cons, but often we’re offended at the very idea. Selling kidneys is so immoral I can only liken it to the woman who goes out on the street and sells sex. It’s an example of a secular taboo. In my view, the full potential of living donation has not yet been achieved without using money. Why are we not maximising deceased donation? We don’t talk about our wishes. Research shows that most people would agree, after death, to organ donation. Yet we leave our loved ones wondering. Ideally, we could change the law but I would advocate that anyone consider donating, no matter what, because, save dragging someone out of a burning building or pulling them out of a frozen lake, where else could you save someone’s life so palpably as this?
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