HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Friday, April 3, 2009

Natalie Cole, Organ Donors and Cash Payments

Natalie Cole went on Larry King Live Wednesday night and discussed her need for a kidney.  Many individuals watching the show have volunteered to provide her with a kidney. Cord Jefferson writing at the Daily Beast thinks that this rather uncomfortable public plea for help leads him to believe that Ms. Cole should be permitted to buy a kidney.  He argues,

On Wednesday night, Natalie Cole announced on Larry King Live that both of her kidneys were failing following a decades-long battle with Hepatitis C; without a kidney transplant, she lamented, she'd be looking at a life of dialysis.  Within minutes of her sharing her illness with the world, dozens of Cole's fans had emailed the show with offers of their organs. . . .    It's a heartwarming story, but it also underscores a major problem in America: the giant gulf between those in need of an organ and those willing to donate one. When patients waiting in an endless line for a kidney transplant are relegated to making on-air pleas for help, something’s seriously wrong with the system.

As Americans everywhere wait to see how Barack Obama will handle medical care, allow me to suggest to the new president a solution: an open, regulated, and legal cash-for-kidneys market in the United States.

It's a subject very near to my abdomen. Last summer, I traveled to Riyadh, Saudi Arabia, to donate a kidney to my ailing father, who lives and works there. By the time I arrived, his kidneys were functioning at 5 percent of their capacity and he was going to four hours of dialysis, three times a week. After the sessions, I would watch him struggle up the stairs, his weary body shaking, belying my childhood memories of riding on his broad, solid shoulders. Giving him my left kidney was an honor, and I'd do it again—even if there weren't thousands of dollars in it for me the next time.

See, like many in the creative underclass of New York, I was gainfully employed, yet still without health insurance. When my father's illness got gradually worse, I eagerly volunteered to donate. But because kidney donation in America is a nonprofit enterprise, the myriad expenses associated with the operation and the years of aftercare fell beyond my ability to pay. Before I could even broach this dilemma with my dad, he wired me thousands of dollars to pay for insurance and initial testing. Would I have gone through with the donation without the money? Probably—only because he was my father. The point is that the offer of money made me absolutely certain I wanted to donate. . . .

The chief argument against a cash-for-kidneys system is that it will summon an outright organ market, one in which the rich procure second chances at life from the poor. Nancy Scheper-Hughes, a professor of anthropology at Berkeley and one of America's most vocal critics of the organ trade, criticizes kidney sales for two main reasons. What she most takes issue with is that organ sellers are often impoverished laborers who return from their surgeries unable to work and without the proper aftercare. Soon, their fee is spent on things other than their health, and they're drinking unclean water and eating bad food, neglecting a body that needs time to recover. The professor's second point is less tangible: She believes it's dangerous to commodify the human body. "It's the sense that body and soul are connected," she once told the Christian Science Monitor, "and selling your body is chipping away at what gives you existence." . . .

I think it’s similar to America's failure to consider legalizing marijuana. Both are supported by many medical professionals, but the political will to change the law exists for neither. Yet every day, 17 Americans die while waiting for a kidney. It’s an organ most of us could give to them easily, if only there were a system in place to compensate us for our trouble. My father was lucky to have my support and the resources to go elsewhere if he didn't. But with such a definite source of life constantly operating just out of the reach, it's a shame that luck comes into the equation at all.

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