Sunday, October 24, 2010

Those Darned Manipulative Living Donors

One of the authors of this article is the Walter Graham, Executive Director of UNOS, the agency that manages OPTN. He is neither a physician, mental health professional, living donor nor transplant recipient. He is but a simple bureacrat.

From the cited article, comes this little gem:

OPTN members also have the responsibility of helping protect potential recipients from hazards that can arise from public appeals.

This hit me on a good day, meaning that I laughed hysterically rather than plot the authors' slow and painful deaths. The paragraph continues (seriously, this is the very next sentence; I didn't skip anything):

The psychosocial evaluation* of all potential live donors is now standard practice.

So in this context, 'hazards' apparently means The Crazy-Ass Living Donor. The desperate, fear-driven, would-be recipient ADVERTISING for a stranger to give them a body part is the person who needs protection, but not the kind, generous (and most likely naive) person who responds to the plea for help.

This attitude isn't a huge surprise. After all, the entire system was built around the needs of the recipient. According to current OPTN policies, the living donor has to be told it's illegal to sell a kidney, but nowhere is it mandated that the recipient must be warned against buying one (sort of like arresting the hooker but not the john). And while living donors are given all the information recipients receive, the opposite does not apply. A few years ago, an OPTN committee member suggested that would-be recipients be informed of the risks of living donation so they'd know what they were asking someone to sacrifice for them. The response from the committee was that the 'poor recipient shouldn't be burdened with that information'. So paternalism is bad when it concerns the living donor, but perfectly acceptable in regards to the recipient.

Just in case, there's any ambiguity floating around, this statement from the same article sums up the transplant industry's attitude nicely:

The OPTN/UNOS Board, committees and staff are intensifying efforts to support transplant candidates by increasing the supply of organs for transplantation.

What's the name of this article again? "Direction of the Organ Procurement and Transplantation Network and United Network for Organ Sharing Regarding the Oversight of Live Donor Transplantation and Solicitation for Organs." (emphasis mine)

But the recipients are the vulnerable population.




*Let me tell you something about that psychosocial evaluation. It's purpose is to ensure A. the donor knows it's illegal to accept payment for the organ, B. the donor is competent to make the decision to donate (and I mean 'competent' in a legal, not psychological sense), C. the donor isn't being overtly coerced to donate. Otherwise, it's a freaking joke.

Delmonico, F., & Graham, W. (2006). Direction of the Organ Procurement and Transplantation Network and United Network for Organ Sharing Regarding the Oversight of Live Donor Transplantation and Solicitation for Organs American Journal of Transplantation, 6 (1), 37-40 DOI: 10.1111/j.1600-6143.2005.01163.x