A Voluntary Solution To Organ Shortages


Windypundit points the way to this short but wonderful post by former Reason editor Virginia Postrel about donating a kidney:

Unless people like Leon Kass get their way, someday patients with failing kidneys will be able to get made-to-order replacements that are exact genetic matches, either through therapeutic cloning or some now-unknown future technology. Now, however, if your kidneys stop working, you have three options: die, go on dialysis (regularly described as "living hell" by dialysis patients and their loved ones), or find a donor kidney. And donor kidneys are in short supply, made shorter by legal restrictions and social taboos.

Last fall, my friend Sally Satel wrote about the issue in general and her own search for a kidney donor. Between the time she wrote the article and the time it appeared in the NYT, I heard about her situation and volunteered as a donor. Our tissues turned out to be unusually compatible for nonrelatives and, when her Internet donor dropped out, I moved from backup to actual donor. We have our surgeries tomorrow morning.

As surgeries go, the procedure is safe and straightforward–far more so than people think. A donor can live a completely normal life with one kidney. The recipientis not so lucky, since a foreign organ requires a lifetime of immunosuppressant drugs. But that's a lot better than the alternative.

Original post here.

Best wishes to both Virginia and Sally.

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  1. Wow!
    That’s puttin’ your kidney where your mouth is.

  2. “As surgeries go, the procedure is safe and straightforward…”

    Is that the procedure where the donor goes out on the town in Tijuana, gets bombed, and wakes up in a bathtub full of ice in his/her hotel room?

    And the scientific community had better ramp up this made-to-order-from-your-own-genetic-material technology, because surely my liver is just about shot. I want to be able to grow a new one suspended in liquid in a jar on my windowsill, just like I used to make rock candy.

    Oh yeah, good luck to donor and donee.

  3. I would love to donate something, but I really can’t. I’m so excited: I just won the lottery!


  4. sage-

    Hilarious post! But, to be serious, I thought it was such a disappointing movie. It started off interesting, and had the potential to raise lots of interesting issues about reality and ethics: How do you know that your memories are real? How do you know that there isn’t a giant hologram just beyond the horizon? And when one of Ewan McGregor’s characters betrays his other character, isn’t he really just fighting for his life in a do-or-die situation?

    But instead they made it 75% crazy chase scenes.

  5. Thoreau: Are you saying Hollywood’s “more chase = more better” formula is wrong?

  6. Good luck to Virgina and her friend.

  7. Leon Kass seems to be a really scary guy. I read an interview with him in the WSJ a few months ago and I am not sure if he means what he said, but if he did, Kass scares the hell out of me. Kass seemed to be saying that his objection to things like stem cell research was not just that some of the technologies may take a life (if you believe that life begins at conception) but that the whole idea of extending life is flawed. Kass talks about the damage to society that would result if people actually started living 100s of years and how such a thing would not be desirable. It is one thing to say that some technologies employ such a repubnant means (like killing children in the womb for our benefit) that no benefit is worth the means. That is an argument I can sympathize with even if I am not entirely convinced that embryos are human beings. To say, however, that extending life is in itself a wrong not a good is disturbing to say the least. What exactly does Kass want, some sort of Logan’s Run society where we Kevorkian people at some pre appointed age whether they need it or not? It seems to me that the first principle of any ethics has to be that life is better than death and existence is better than non-existence. From this premise you can then do the hard part which is working out the exceptions; for example when does life become so painful or unpleasant that it is no longer worth living or at what point to medical treatments become so barbaric that cannot be justified by result. Kass, in contrast seems to be saying that life is not an unqualified good.

    Maybe I am wrong about Kass and he doesn’t really think this. If anyone is familiar with his views, I would love to hear why I am wrong and how he doesn’t really believe this. Otherwise, Kass is a serious nutcase.

  8. Timothy-

    I like cheesy action flicks as much as the next guy. But when a movie starts off with a thought-provoking premise and develops an interesting scenario, and then tosses it all aside in favor of chase scenes, yeah, that kind of sucks.

  9. this probably sounds like a really stupid question to those in the know – but i still wonder:

    does a genetically identical lab created organ through stem-cell technology or whatever technology in the future negate the concern over rejection and the need for the anti-rejection drugs? or are these still needed because even though the new organ is genetically identical to the rest of your body, it is still kind of a foreign object subject to rejection?

  10. John,

    I’ve read some of Kass’ articles for “First Things” and “Commentary,” and yes, he is a very scary guy. He has a nearly-lethal case of the nostalgias. I can’t find it anymore which may mean it’s not on the Web now, but I recall an article he wrote in which he advocated for women to behave “coyly” because that would make men behave gallantly, and obviously the world was a vastly better place before women had opinions and sex. There are good arguments for not sleeping with every male who offers, and good arguments I have made to friends of mine for not sleeping with many specific ones, but he focused on the idea that chastity in a woman invariable inspires chivalry in men. There were no ugly facts to mess up his lovely romance.

    I read the WSJ article you mentioned, too, and it seems to me that he objects to curing illnesses on aesthetic grounds. Supposedly we learn important lessons from having terminal illnesses. My mother and husband are both mildly diabetic, and my maternal grandmother and her mother were also diabetic. My turn, and my sons’, is coming on this one. Mr. Kass seems to think we should just make our peace with bad pancreases and die. Needliess to say, I don’t agree with him. I’m not willing to die just so that other people can learn something from how well I do it.

  11. Kass has the president’s ear on all scientific matters. And yeah, he is that much of a nutjob and more. In some future book of terrible predictions and ideas, he’ll have a chapter all his own. Google his name along with “opposed ivf” for just a taste.

    How about another round of applause for those founding fathers, and that rule about elections every four years?

  12. Karen,

    My mother died of cancer last year. I suppose Kass should be congratulating me on all of the wonderful life lessons I have learned from the experience of watching her die. Me, I would prefer just to have my mother back as I am sure you would prefer to see your children avoid all of the great life lessons they will learn by having diabetes. I am as big of a Bush defender as they come, but I would agree Kass should be nowhere near anyone in power.

  13. John, my condolences on the loss of your mother.

  14. Well, if we expanded the human lifespan enough we would eventually run into some pretty nasty population problems, but it would have to be far beyond 100 and it would have to be across the board. Somehow, I don’t think that’s what Kass is getting at though.

    Of course, if we’d just get off our asses and build a damn moon colony we could begin to mitigate some of those problems before they even start.

  15. That’s incredibly generous of Virginia. I thought libertarians were heartless, selfish exploiters? 🙂

    Best wishes to her and her friend.

  16. Stretch,

    There are some serious social problems that would come with hugely extended lifespans. Clearly, society would be remade into something a lot different than today. Staticians say that even if it were impossible to die of natural causes you still would have an average lifespan of around 500 years because of the threat of accident. Hang around long enough and eventually you will run into a serial killer or get struck by lightening. No one has ever lived that long or has any idea what doing so would do to us psychologically. Perhaps people would get so bored with life that suicide would become acceptible after a certain age. Combine long lifespans, overpopulation, and virtual reality technology, you can imagine a world in which people say to hell with the real world and put their bodies in some kind of vegitative but sustainable state and live in something akin to the movie The Matrix. How they would ever come back to the real world is an interesting question. I always thought people choosing to live in the matrix and not being able to get out because the situation on earth was so overcrowded was a lot better premise to that rediculous movie than the idea of machines using humans as power supplies. Regardless, like getting old, those problems sure beat the alternative or if they don’t I would like to find out.

  17. Asimov’s Spacers had extended lifespans. They did okay until he decided to kill them off in the later novels. Not that one should confuse fictional characters with real life or anything.

  18. Regardless, like getting old, those problems sure beat the alternative or if they don’t I would like to find out.

    I agree, my only point was that there are practical considerations about drastically expanding our lifespan that should be taken into account. Many people wave off any objections to new reasearch because the most vocal detractors are nutjobs like Kass, who emphasize the emotional over the rational.

  19. The Island was just a crappy remake of Parts: The Clonus Horror.

  20. John, Flesh that paragraph out a little bit, add a romantic interest, and you could probably get a production deal!

  21. Asimov’s Spacers had extended lifespans. They did okay until he decided to kill them off in the later novels.

    Actually, in Asimov’s books, the first wave of interstellar settlers from Earth had extended lifespans. Then they went into various forms of stable decadence, enjoying their long lives, and didn’t carry out any secondary expansion. Centuries later, a second wave of expansion by short-lived, but industrious, Earthlings started the colonization of the entire galaxy. I don’t know that Asimov ever touched on what exactly happened to those few original colonies after the Caves of Steel period.

    (And why do I remember this from a book I read once fifteen years ago?)

  22. Two quick points from a medical student who spends far too much time lurking here when he should instead be studying about people’s kidneys:

    1) In response to the question regarding rejection of genetically identical tissue- No immunosupressive drugs would be needed. Your body recognizes the structures of certain combinations of proteins expressed by your cells to help determine the “foreign-ness” of living tissue. Thus, no genetic differences, no problem. This is why the first successful transplants were done between identical twins.

    2) Although I loath to do it, I have to offer a partial defence of Kass’s positions (at least those expressed in most of his writings). I’ve done some work in the bioethics field and in the vast majority of instances, Kass is not a complete luddite. However, he does have a somwhat classical view of the meaning of human existince (and a somewhat religiously inspired one) and is therefore very hesisitant about new developements in biomedicine which may radically change the human experience. While I think he takes this too far (way, way, too far), I must conceed that a “look before you leap” policy with regards to some of these technological changes isn’t the most ridiculous idea in the world

  23. The Spacers weren’t so obviously in a decline in The Caves of Steel and The Naked Sun. In fact, in the latter book, the Earth authorities wanted to believe that the screwed up planet that Bailey had visited (which was in a definite decline) was typical of all of the Spacer worlds. In fact, Baliey thought it wasn’t and that Earth needed to revitalize itself by beginning to colonize space again. Incidentally, The Caves of Steel would make a fine feature film, provided that a director would actually stick closely to the book. Asimov has been poorly served by Hollywood so far.

    It wasn’t until the later books that Asimov decided to play with the idea that Spacer society would fail (and, in Foundation and Earth, he tells us that Spacer society did, finally, collapse, with one bizarre exception).

    Sorry for the Asimov moment, everyone. You may now return to your original programming.

  24. I’m surprised no one has brought up the Howard Families from Heinlein. I thought “Methusulah’s Children” was loads of fun, as were most of the Lazarus Long books. Then again, I have red hair and consequently gave points to the books for having characters that could have looked like me in ’em. Obviously not as artful as Asimov’s stuff, but I’d still like to hang out with Lazarus’ mother.

  25. What exactly does Kass want(?)

    Life is fun. Can’t have people having fun.

    Besides, we might have problems funding Social Security and Medicare. (Oh, wait. Never mind.)

  26. Pro Libertate –

    “It wasn’t until the later books that Asimov decided to play with the idea that Spacer society would fail”

    Actually, Asimov did plan very early on for the Spacers to decline & fall. See short story “Mother Earth” – It concludes with the Earth Prezzzident admitting that he provoked the war coz he forsees Spacer comeuppance yadda yadda yadda ie Like many another Asimov character, he makes a long speech accurately predicting the next thousand years.


  27. SM, I’ve always wondered if that was canonical in Asimov’s eyes. “Mother Earth” certainly changes things considerably, making Earth much less pathetic than in the novels. I’ve always thought that he didn’t really count the short story. Though I think you have a point that things did kind of go in the direction predicted.

  28. The Spacers weren’t so obviously in a decline

    That’s why I said “stable”. 🙂

  29. John: you’re not wrong. Kass is a totalitarian anti-life nutjob. That he has the influence he does is one of my top complaints with the Bush administration.

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