Great Ideas & Kidney Donation
A year ago, I made the choice to donate my kidney to a stranger.
I'd been inspired by a lot of people, including Dylan Matthews, a Vox journalist whose account of "altruistically" donating his kidney introduced me to the idea in the first place. Peter Singer, the Australian philosopher who was instrumental in the genesis of the effective altruism movement, gives similar reasons.
Taken together, their argument is that the vast majority of healthy people have double the kidneys they will ever need. A small minority of people, however, suffer from severe, chronic kidney diseases. The National Kidney Foundation reports that "In 2016, over 500,000 patients received dialysis treatment, and over 200,000 lived with a kidney transplant." If one person donates one of their kidneys to someone who desperately needs it, they will give on average 9-10 additional years of life to the recipient. The risk to the donor is quite low: the rate of complications for kidney donation surgery is less than that of childbirth, and donors are overwhelmingly likely to be back to normal activities within six weeks of their donation.
So, the risk is low, the potential upside for the recipient is enormous. The argument gets more convincing: Altruistic kidney donation, ie. donating to a stranger, can start a "chain" of donations that results in many recipients enjoying, collectively, many more years of life. (If you're curious how the "chain" works, you can find more info here, and below.) In my case, my donation will result in seven people receiving kidneys, giving 63-70 more years of life to the recipients, as well as all the happiness, memories, and experiences that they and their loved ones will experience together in all those extra years.
So far, so good. I could do a lot of good with this one relatively small decision. What is 6 weeks of recovery time when I can give 60+ years to others?
Another, more personal reason eventually compelled me to make the decision to donate a kidney: my job. In teaching Great Ideas, I cover an entire unit on Ethics. We discuss Kant and the categorical imperative, Aristotle and virtue ethics, Bentham & Mill and utilitarianism. In studying utilitarianism, we also consider effective altruism, its modern incarnation, which asks how we can do the most good with what we have.
I realized that, in order to do the most good with what I have, to be a model for my students and live the values I was trying to teach them, I had to make this choice. My students will hopefully remember their ethical instruction more vividly, and with more of an understanding of its real-world value, if they see their teacher practicing what he preaches. And perhaps, in the future, they'll be moved to do the most good with what they have.
Not to imply that there are only upsides to donation. The process has been long, involving multiple rounds of blood tests, a daylong set of appointments with social workers and psychologists and nephrologists, and a lot of my time and energy. It's not easy, and it's not something that every healthy person should do. My transplant hospital told me that they only get 4-5 non-directed kidney donors per year. However, I do believe that every healthy person should at least consider it, with a realistic eye at the costs and benefits.
In a coming post, I'll write about the impact I think my decision to donate has made so far, and about how I'm trying to teach about (and in spite of) my decision. The process, from idea to surgery, has been a long but mostly painless year. Coronavirus has had a deep impact in the last month, however, even causing the hospital to briefly cancel all surgeries, and causing me to doubt whether I truly wanted to go through with donation. I'll talk more about that soon, too.
In the meantime, my donation date is two days away. Wish me luck - hopefully I won't need it.