Would My Story Get Me a Kidney?
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Would My Story Get Me a Kidney?

In 2004, a businessman and a physician launched matchingdonors. com to see whether the Internet could aid people needing organ and tissue transplants. Hundreds of people now use the site to tell their stories directly to the public. Patients tell how they got sick, what it's like to be medically dependent, what a transplant would mean to them. Married people ask for organs for their spouses, and parents describe the struggles of their children. The site also features pictures of the donors and recipients it has matched.

Direct appeals to the public for an organ or tissue are not new. Over the years, families have enlisted local television stations and newspapers for help finding a donor. I usually cringe when I see this: these families appear to be cutting in front of everyone else on the waiting lists in their regions.

Yet solicited "directed dona-tions"—donations to an identified individual—are increasingly common. The number of kidneys coming from living donors exceeds the kidneys coming from the dead, and ever more people are stepping forward to donate parts of their livers. Usually these donors want to help family members and close friends, but not always. When basketball player Alonzo Mourning needed a kidney transplant in 2003, dozens of people completely unknown to him volunteered to donate.

In 2003, former literature professor Zell Kravinsky was prepared to donate a kidney, but specifically to someone poor and black. Never mind that he didn't know anyone like this. Of course, transplant policy bars donations to groups, and for good reasons. In a 1994 case, a murder victim's family agreed to donate his organs on the condition that they go only to white people. The murder victim had been a member of the Ku Klux Klan, and, as if to add insult to injury, his murderer was black. In the soul searching that followed this case, the United Network for Organ Sharing, the federal organization overseeing organ allocation in the United States, adopted a policy barring donation to groups. For this and other reasons, several hospitals turned Mr. Kravinsky away, until an institution in New York was clever enough to introduce him to someone who met his criteria. After the introduction, the professor-turned-philanthropist was no longer donating to a group but to a woman he knew by name. Web sites make such introductions possible. Shopping the Internet for organ recipients functions like directed donation to an individual, but the process practically invites donation to groups.

What's more, recipients' stories also mark off groups. I'm not waiting for an organ transplant, but what if I were? Would anyone find my story compelling? Here's a draft: "I'm just past fifty, and my partner and I have an Australian terrier who's sweet as peaches. I have a large family: an aging Mom and Dad, siblings, nieces, a nephew, a circle of cousins, and more. My partner's small family rounds out the domestic circle, but unfortunately no one on either side is in a position to donate. I work as a professor, acknowledge no religion, and make mosaic art in my spare time. I've been sick a long time. It's been devastating. I would be grateful beyond speech to anyone who could help." How would my story stack up against that of a sick Mom or Dad with children, someone bankrupted by medical debt, someone much younger, or someone friendlier to religion?

Ever more people are willing to face the risks of organ and tissue removal to help someone they know. Ever more will also face these risks without a direct personal connection. A few institutions in the United States now accept organs from living people who have no intended recipient; they treat the organ as if it came from a deceased donor and match it to the waiting lists. But most people still take no steps to donate their organs after death, even though that involves no medical harm whatsoever. By turning to living directed donations, we incur degrees of harm that would be virtually unnecessary if people freely donated their organs...