Yesterday I wrote a post admonishing DePaul University’s decision to suspend Dr. Finkelstein from teaching classes this academic year. Today a good friend and fellow DePaul alumnus wrote a contrary article defending DePaul’s decision to deny Finkelstein tenure. I felt it important to call attention to some issues that must not go unchallenged.
First and foremost is the most recent action by DePaul to cancel Dr. Finkelstein’s classes and place him on administrative leave. Further, he was barred from his office which held his personal and professional effects. This indignity and improper process of dismissing a professor is the most unsavory of occasions that has arisen from this entire debacle. The American Association of University Professors (AAUP) has now twice written DePaul University sharing its concern over the university’s treatment toward Dr. Finkelstein.
As I count Dr. Finkelstein has four different to protest:
1) His denial of tenure.
2) His denial for an appeal of the tenure decision.
3) His placement on administrative leave (and effective cancellation of his classes).
4) His being banned from his personal office.
1 – Dr. Norman Finkelstein’s denial of tenure.
Rachel’s article most specifically addresses Dr. Finkelstein’s denial of tenure and her reasoning for the ‘apt’ decision. However, it should be noted how the process developed. First the political science department committee voted and arrived at a 9-3 for tenure vote. Second it went to the LA&S college tenure committee, which voted 5-0 for the tenure. Third, at the university level tenure committee however voted 2-4 against tenure. In sum he was overwhelmingly supported by the tenure committees 16-7.
Rachel’s argument for support of the denial of tenure primarily rests on the reasons given by the department committee minority opinion – written by the three opposing faculty. The article, "Academic Freedom On Trial, Peg Birmingham, a DePaul University professor, does a suburb job of showing the shallow and insipid claims those against Dr. Finkelstein’s scholarship are alleging.
Of course my own conviction of scholarly merit will hold little weight. However, on the radio show Democracy Now two Middle-East expert scholars praised Dr. Finkelstein’s work: "We speak to two world-renowned scholars in these fields: Raul Hilberg, considered the founder of Holocaust studies, and Avi Shlaim, a professor of international relations at Oxford University and an expert on the Arab-Israeli conflict. Shlaim calls Finkelstein a "very impressive, learned and careful scholar", while Hilberg praises Finkelstein's "acuity of vision and analytical power." Hilberg says: "It takes an enormous amount of courage to speak the truth when no one else is out there to support him." His academic credentials far exceeded those of most political science professors that were tenured at DePaul and his international attention and praise are representative of such.
Of course, Dr. Finkelstein claim that DePaul University was third rate is simply accurate. As an alumnus of the school it takes a certain amount of humility to say this, but DePaul has for years been ranked as a third-tier school by the Princeton Review. The university has been committed to being a teaching institution and not a researching one (which again emphasizes that a professor with five published books has certainly published enough for tenure). It is simply stating factually and by category what DePaul University was and still is, a third-tier national university.
2 – His denial for an appeal of the tenure process decision.
Dr. Norman Finkelstein’s denial for an appeal of the tenure decision is also inconsistent with its faculty handbook. In a letter from the AAUP the president stated he was concerned with such a denial for appeal. He wrote, “Our concerns arise when you go on to assert that ‘there is simply no basis for any claim that the UBPT failed to uphold the standards and processes set forth in the Faculty Handbook.’” In our view, it is precisely that assertion as well as the question whether the administration similarly failed that bear on the claims by Professors Finkelstein and Larudee that impermissible considerations—involving violations of their academic freedom—contributed significantly to the adverse decisions in their cases.” This seems an undue stance by the university, signaled by the AAUP.
3 – His placement on administrative leave (and effective cancellation of his classes).
After being denied tenure Dr. Finkelstein, as is done with other professors who are denied tenure, was allowed one more year of teaching at DePaul. With rumors that the university might try to bar Finkelstein from teaching the next year it came at little surprise that the university placed him on administrative leave for the year and thus effectively canceling his classes. Another letter by the AAUP warned the university that this was uncharacteristic of the usually process afforded to professors. Dr. Finkelstein was rightly troubled by the development and claimed he would perform a sit-in and hunger strike if necessary so as to be afforded the right to teach.
4 – His being banned from his personal office.
The letter by Dean Suchar, which I shared yesterday, is the apex of this entire spectacle: a full blown circus with the dean miming as a teenaged angst ridden clown. There is little more that needs to be said on this issue.
Rachel has her reasons for suspecting Dr. Finkelstein’s fidelity to truth. Her particular and peculiar story is interesting, but not necessarily insightful enough for me to disregard the more than 1,000 pages of published work he has produced and been praised for. I would like to point out that some of her reservations in supporting Dr. Finkelstein’s work come from his ‘lack of empirical evidence’ in which I would respond where then is your evidence that besides a rather quirky personal anecdote? The empirical evidence you seem to castigate Finkelstein for lacking also seems lacking in your assertions.
It is no secret that Dr. Finkelstein does not play nice. However, that is not what his project is about – it was about truth. This in no way is to suggest this man a martyr, but he is at least a model.
I too have stories from Finkelstein and I will share them here:
The first is when taking a class on Utopias. While in class he recollected how his mother was called to testify, sometime in the 1990’s, against the woman who ran the concentration camp Dr. Finkelstein’s mother was sent to during WWII. Dr. Finkelstein traveled to Europe with his mother to support her during the emotionally grueling ordeal.
At the trial his mother testified against the head of the camp. The ex-Nazi was now an old woman, a hallow shell. She was a mere run-down ghost of what she once so unfortunately was.
After Finkelstein’s mother testified they walked back toward the hotel. Along the way they passed the very woman Finkelstein’s mother had just testified against – who was on bail. Finkelstein’s mother was so enraged by her presence she lost all control and demanded that Norman should attack the woman. She scolded him, “They treated us like dogs, Norman! Like dogs. Get her, Norman! Get her!”
Dr. Finkelstein stopped his lecture there. The entire room was enraptured. My retelling does it no justice. Then of course someone asked, “Well, what did you do?” And he said quite seriously, “I will never tell.” Then what commenced was the best classroom discussion on ethics I have ever had. .
Another time Dr. Finkelstein, on the last day of class on Utopias, asked each student if they believed that political utopias were someday possible for humanity. Of course there were a variety of answers most were of the type that you would expect from idealistic and optimistic undergraduates.
When it was my turn I answered that, no there was no chance for a political utopia. He stopped and mentioned how surprised he was that I would believe that. That moment and that exchange has stuck with me for years now. I always felt like I disappointed him, that I hadn’t gleaned the possibility and promise of humanity from the texts and fellow peers. However, if anything has proven my answer right it has been how Dr. Finkelstein has been treated by the ‘political’ process.
Thursday, August 30, 2007
Wednesday, August 29, 2007
Academic Freedom In Question
On Friday, August 25th Dr. Norman Finkelstein - who was recently denied tenure at DePaul University in Chicago - received this terse email from Dean Suchar:
--------------------------------------------------------------------
Prof. Finkelstein - Professor Budde has informed me that you have asked for office space for your books. We do not have office space assigned to you for the coming academic year. I will look into whether we can make space available for you and either I or Professor Budde will get in touch with you next week with more information.
In the meantime, you will not have access to your old office space. To the extent that you left personal belongings in your old office space, we can discuss a plan for their return to you when I get in touch with you next week. You should not plan on moving into any office space tomorrow, as that option is not available to you.
I will contact you next week with more information.
Dr. Charles (Chuck) Suchar
Professor and Dean
College of Liberal Arts and Sciences
DePaul University
--------------------------------------------------------------------
Besides this, Dr. Finkelstein was placed on administrative leave for the academic year, effectively canceling his classes, one ironically entitled 'Freedom and Empowerment.' This because the controversy of his denial of tenure and class cancellations go to the heart of the academe; academic freedom.
The American Association of University Professors (AAUP) - wrote DePaul's president after it was announced that Dr. Finkelstein's classes would be canceled. The letter warned that the school's conduct toward the professor was not in accordance with general procedures usually afforded to professors. The (AAUP) already voiced concern over DePaul's denial to allow Dr. Finkelstein to appeal the tenure decision (which consequently held a majority (9-3) recommendation by the departmental tenure committee and a unanimous (5-0) recommendation by the Personnel Committee for the College of Liberal Arts and Sciences though did not pass by marjority at the university committee level).
Most regretably, DePaul and Dr. Finkelstein will both lose face in this insipid and certainly uninspiring spectacle that bedazzles no one all while at the loss of academic freedom.
Further, DePaul in its debauched handling of the entire process has further strengthened Dr. Finkelstein's career thesis: that ultra-sensitive feelings towards Jews and specifically the state of Israel borne from Holocaust guilt has lead to the inability to criticize Israeli policy. DePaul has made him his own self-fulfilling prophecy.
I personally took classes from Dr. Finkelstein and it is a shame such a professor is asked to leave in such a manner. The sum of the academe is lessened by such a loss.
--------------------------------------------------------------------
Prof. Finkelstein - Professor Budde has informed me that you have asked for office space for your books. We do not have office space assigned to you for the coming academic year. I will look into whether we can make space available for you and either I or Professor Budde will get in touch with you next week with more information.
In the meantime, you will not have access to your old office space. To the extent that you left personal belongings in your old office space, we can discuss a plan for their return to you when I get in touch with you next week. You should not plan on moving into any office space tomorrow, as that option is not available to you.
I will contact you next week with more information.
Dr. Charles (Chuck) Suchar
Professor and Dean
College of Liberal Arts and Sciences
DePaul University
--------------------------------------------------------------------
Besides this, Dr. Finkelstein was placed on administrative leave for the academic year, effectively canceling his classes, one ironically entitled 'Freedom and Empowerment.' This because the controversy of his denial of tenure and class cancellations go to the heart of the academe; academic freedom.
The American Association of University Professors (AAUP) - wrote DePaul's president after it was announced that Dr. Finkelstein's classes would be canceled. The letter warned that the school's conduct toward the professor was not in accordance with general procedures usually afforded to professors. The (AAUP) already voiced concern over DePaul's denial to allow Dr. Finkelstein to appeal the tenure decision (which consequently held a majority (9-3) recommendation by the departmental tenure committee and a unanimous (5-0) recommendation by the Personnel Committee for the College of Liberal Arts and Sciences though did not pass by marjority at the university committee level).
Most regretably, DePaul and Dr. Finkelstein will both lose face in this insipid and certainly uninspiring spectacle that bedazzles no one all while at the loss of academic freedom.
Further, DePaul in its debauched handling of the entire process has further strengthened Dr. Finkelstein's career thesis: that ultra-sensitive feelings towards Jews and specifically the state of Israel borne from Holocaust guilt has lead to the inability to criticize Israeli policy. DePaul has made him his own self-fulfilling prophecy.
I personally took classes from Dr. Finkelstein and it is a shame such a professor is asked to leave in such a manner. The sum of the academe is lessened by such a loss.
Tuesday, August 28, 2007
Should Seminaries Give Atheists Scholarships?
It a strange thing to be sure that in this day of such rampant liberalism such a question is even given a moments ponder – should seminaries subsidize the cost of theological education of avowed atheists? It is an even stranger thing that such things happen – and they do happen.
The repercussions are of course that some hopeful Christians entering seminary are awarded less or even no scholarship monies. This could even lead a possible seminarian to conclude that they are not financially able to attend seminary.
There seem to me a few reasons one might argue for permitting seminaries the possibility in awarding atheists scholarships: 1) a call to diversity, 2) a hope of conversion and 3) a commitment to meritorious awarding.
A Call to Diversity
On one hand, one reason seminaries may justify funding atheists is in the desire to diversify the view and theological perspectives of their students. Brown v. Board of Education fell heavily on the reasoning that there was a psychological and sociological benefit to diversity itself. Theological schools could crassly want diversity for diversity’s sake, or a more refined belief that a plethora of perspectives lead ultimately to better theology. Even the Vatican Councils have a designated ‘devil’s advocate’ that is to play against the prevailing arguments of the day in an attempt to ensure that every conceivable viewpoint is considered.
On the other hand, what theological diversity is needed in the seminary? A denominationally aligned seminary already has an orthodoxy and theological perspective. Certainly, if anything is orthodox in Christian doctrine it is the belief that God exists. Theological education presupposes God’s existence; to ‘do’ theology is already to ‘speak of God.’ So what benefit would it be to have the antithetical perspective introduced in theological classrooms? Further, what assurance would there be that such a ‘token’ atheist would share his or her radically divergent perspective?
I say, there is need for theological diversity in seminaries. A dialogue between the Church, faculty and staff is needed to decide to what degree such diversity should be welcomed; nevertheless, atheists can never properly constitute a ‘theological perspective.’ They are quite literarily ‘a-theist’ in name: they are indifferent to God. Their speech about God is in silence, muted. Thus they can give no proper perspective of God. Their diversity would be a false one.
A Hope for Conversion
On one hand, some might argue that funding an atheist’s theological education could lead them to convert to Christianity. By being steeped in a Christian community, immersed in the history of Christianity and introduced to the Word an atheist would be more likely to be converted to the faith and thus it would be worthwhile to financially support an atheist in attending seminary.
On the other hand, seminary is not the place to convert atheists. Its mission is to primarily train the ministerial leadership of the Church. The monies the seminaries are allocated by patrons are earmarked for this mission, not for conversion and evangelism. Further, the seminary - though obviously a Christian environment - is not necessarily the most effective place to instruct someone on why and how to be a Christian. Thus, it would be both spiritually ineffective and financially improper to use the seminary for such ends.
I say, the seminary is part of the Church and has the same desire to see people turn to the belief in Christ; however it functions different than churches, focusing more on supporting vocations than fostering conversions. This should not be read as an attempt to bar atheists from seminaries who may want to use the institution as an avenue for faith, but rather as a proscription in allocating funds to such individuals for such projects.
A Commitment to Meritorious Awarding
On one hand it may be said that as seminaries are graduate institutions they should reward funding primarily – or perhaps solely – on merit; be it academic, leadership, or relevant experience. Academically, graduate schools must take into account the merit of students entering programs and with financial incentives attract students whom can continue to keep or raise the standard of academic excellence of the school. This also is the case for other meritorious considerations such as past careers and leadership experience. The fact that someone is an atheist need not impinge upon such considerations. Generally, it is the overall strength of the applicant rather than theological convictions that can best be quantified and objectified and thus judged. This both expedites the process while also offering the most reliably way to evaluate students. The financial awarding of scholarship by seminaries need not be different from other graduate schools that primarily if not simply consider the merit of the student while ignoring other such subjective qualities such having such and such political party affiliations or having or not having faith.
On the other hand, seminaries are more than mere graduate schools. It is more an accident than the essence of a seminary. And so, academic excellence, leadership ability and the like are a distant secondary to the most important commitment in the financial determination for seminaries: does the candidate have a viable vocation in leading the Church? Obviously, an atheist cannot answer in the affirmative. Though meritorious considerations should be made to those candidates who can answer positively it must be the first qualification that drives the second. The seminary is not a religious studies department - it is a religious studies department and much more. The seminary should care more about the sanctification of their candidates than their qualifications.
I say that seminaries are not equivalent to other graduate schools; they are qualitatively different, and in following so should the students be qualitatively different. Students that are funded by seminaries should be chosen by qualities that reflect their Christian life; atheists that do no have such a life cannot reflect such qualities.
It seems that though we should not bar atheists from seminaries such institutions should not fund them either. As an atheist who received – and accepted - a full-tuition scholarship and stipend from my institution it seems that perhaps I am making a hypocritical argument; but I do not believe so. I know that I do not believe the seminary should have offered me a scholarship and I am absolutely certain I should not have received such a generous one; however, my argument rested in the fact that I believe seminaries should not offer atheists scholarship, not if I believed it prudent for atheists to accept scholarships from seminaries.
The repercussions are of course that some hopeful Christians entering seminary are awarded less or even no scholarship monies. This could even lead a possible seminarian to conclude that they are not financially able to attend seminary.
There seem to me a few reasons one might argue for permitting seminaries the possibility in awarding atheists scholarships: 1) a call to diversity, 2) a hope of conversion and 3) a commitment to meritorious awarding.
A Call to Diversity
On one hand, one reason seminaries may justify funding atheists is in the desire to diversify the view and theological perspectives of their students. Brown v. Board of Education fell heavily on the reasoning that there was a psychological and sociological benefit to diversity itself. Theological schools could crassly want diversity for diversity’s sake, or a more refined belief that a plethora of perspectives lead ultimately to better theology. Even the Vatican Councils have a designated ‘devil’s advocate’ that is to play against the prevailing arguments of the day in an attempt to ensure that every conceivable viewpoint is considered.
On the other hand, what theological diversity is needed in the seminary? A denominationally aligned seminary already has an orthodoxy and theological perspective. Certainly, if anything is orthodox in Christian doctrine it is the belief that God exists. Theological education presupposes God’s existence; to ‘do’ theology is already to ‘speak of God.’ So what benefit would it be to have the antithetical perspective introduced in theological classrooms? Further, what assurance would there be that such a ‘token’ atheist would share his or her radically divergent perspective?
I say, there is need for theological diversity in seminaries. A dialogue between the Church, faculty and staff is needed to decide to what degree such diversity should be welcomed; nevertheless, atheists can never properly constitute a ‘theological perspective.’ They are quite literarily ‘a-theist’ in name: they are indifferent to God. Their speech about God is in silence, muted. Thus they can give no proper perspective of God. Their diversity would be a false one.
A Hope for Conversion
On one hand, some might argue that funding an atheist’s theological education could lead them to convert to Christianity. By being steeped in a Christian community, immersed in the history of Christianity and introduced to the Word an atheist would be more likely to be converted to the faith and thus it would be worthwhile to financially support an atheist in attending seminary.
On the other hand, seminary is not the place to convert atheists. Its mission is to primarily train the ministerial leadership of the Church. The monies the seminaries are allocated by patrons are earmarked for this mission, not for conversion and evangelism. Further, the seminary - though obviously a Christian environment - is not necessarily the most effective place to instruct someone on why and how to be a Christian. Thus, it would be both spiritually ineffective and financially improper to use the seminary for such ends.
I say, the seminary is part of the Church and has the same desire to see people turn to the belief in Christ; however it functions different than churches, focusing more on supporting vocations than fostering conversions. This should not be read as an attempt to bar atheists from seminaries who may want to use the institution as an avenue for faith, but rather as a proscription in allocating funds to such individuals for such projects.
A Commitment to Meritorious Awarding
On one hand it may be said that as seminaries are graduate institutions they should reward funding primarily – or perhaps solely – on merit; be it academic, leadership, or relevant experience. Academically, graduate schools must take into account the merit of students entering programs and with financial incentives attract students whom can continue to keep or raise the standard of academic excellence of the school. This also is the case for other meritorious considerations such as past careers and leadership experience. The fact that someone is an atheist need not impinge upon such considerations. Generally, it is the overall strength of the applicant rather than theological convictions that can best be quantified and objectified and thus judged. This both expedites the process while also offering the most reliably way to evaluate students. The financial awarding of scholarship by seminaries need not be different from other graduate schools that primarily if not simply consider the merit of the student while ignoring other such subjective qualities such having such and such political party affiliations or having or not having faith.
On the other hand, seminaries are more than mere graduate schools. It is more an accident than the essence of a seminary. And so, academic excellence, leadership ability and the like are a distant secondary to the most important commitment in the financial determination for seminaries: does the candidate have a viable vocation in leading the Church? Obviously, an atheist cannot answer in the affirmative. Though meritorious considerations should be made to those candidates who can answer positively it must be the first qualification that drives the second. The seminary is not a religious studies department - it is a religious studies department and much more. The seminary should care more about the sanctification of their candidates than their qualifications.
I say that seminaries are not equivalent to other graduate schools; they are qualitatively different, and in following so should the students be qualitatively different. Students that are funded by seminaries should be chosen by qualities that reflect their Christian life; atheists that do no have such a life cannot reflect such qualities.
It seems that though we should not bar atheists from seminaries such institutions should not fund them either. As an atheist who received – and accepted - a full-tuition scholarship and stipend from my institution it seems that perhaps I am making a hypocritical argument; but I do not believe so. I know that I do not believe the seminary should have offered me a scholarship and I am absolutely certain I should not have received such a generous one; however, my argument rested in the fact that I believe seminaries should not offer atheists scholarship, not if I believed it prudent for atheists to accept scholarships from seminaries.
Sunday, August 26, 2007
Selling Kidneys: Part II - Living Kidney Tx
We should agree that cadaveric donations cannot fully satiate the demand for kidneys (see Part I).
In a desire to explore all viable medical and ethical options to increase the number of kidney transplantation one should then turn to living kidney transplantations.
Surprisingly living transplantations came before cadaveric transplantations, usually between twins when immunosuppressant drugs were still only marginally effective or inexistent. For a while cadaveric donation (CD) became much more common then living donations (LD), but through the 1990's LD become an accepted medical procedure between family members or related living donors (RLD). Following this, emotionally-related living donations become acceptable. Thus, between 2001-2003 there were more LD than CD txs (See OPTN database). Though now there is an almost equal number between living and cadaveric donations.
Moreover, LD are usually preferable to CD txs because LD can be done preemptively, before a patient begins to undergo dialysis. This noticeably decreases the morbidity and mortality rates of the recipients who were pre-emptive. Further, the longer a patient is on dialysis the less effective the kidney transplantation will be in improving the quality and quantity of life.
Of course, during this time the LD operation (nephrectomy) became much safer, less invasive, and offered a quicker and less painful recovery time for the patient. Two reasons for this: 1) growing experience in the field from doctors who began to specialize in the procedure and 2) laparoscopic technology that bypassed the need for opening the abdominal cavity of the donating patient.
The procedure has become so safe that most hospitals now allow for non-direct donations or sometimes called 'good-Samaritan' donations. This is when the donor does not know the recipient. This is the type of donation I went through (see Donating a Kidney).
To say anecdotally that the procedure is safe does not likely reassure the modernist mind. So, cautiously and pessimistically the surgical mortality (death) rate is around <.005% or death in 1 in 20,000 cases. The chance of complication during surgery or the morbidity rate is a little higher, around <.007% (See OPTN).
It seems that this 'minor major' surgery is a relatively safe procedure. Living transplantations then might be a viable means to procuring more kidneys. The next post will then begin to look at the ethics surrounding living kidney procurement options – most specifically at direct financial incentive options.
Post Script
I want to thank my friend and blog-resident surgeon Jessica Clevenger for making sure I am not spoofing on any medical facts or jargon. Thank you.
In a desire to explore all viable medical and ethical options to increase the number of kidney transplantation one should then turn to living kidney transplantations.
Surprisingly living transplantations came before cadaveric transplantations, usually between twins when immunosuppressant drugs were still only marginally effective or inexistent. For a while cadaveric donation (CD) became much more common then living donations (LD), but through the 1990's LD become an accepted medical procedure between family members or related living donors (RLD). Following this, emotionally-related living donations become acceptable. Thus, between 2001-2003 there were more LD than CD txs (See OPTN database). Though now there is an almost equal number between living and cadaveric donations.
Moreover, LD are usually preferable to CD txs because LD can be done preemptively, before a patient begins to undergo dialysis. This noticeably decreases the morbidity and mortality rates of the recipients who were pre-emptive. Further, the longer a patient is on dialysis the less effective the kidney transplantation will be in improving the quality and quantity of life.
Of course, during this time the LD operation (nephrectomy) became much safer, less invasive, and offered a quicker and less painful recovery time for the patient. Two reasons for this: 1) growing experience in the field from doctors who began to specialize in the procedure and 2) laparoscopic technology that bypassed the need for opening the abdominal cavity of the donating patient.
The procedure has become so safe that most hospitals now allow for non-direct donations or sometimes called 'good-Samaritan' donations. This is when the donor does not know the recipient. This is the type of donation I went through (see Donating a Kidney).
To say anecdotally that the procedure is safe does not likely reassure the modernist mind. So, cautiously and pessimistically the surgical mortality (death) rate is around <.005% or death in 1 in 20,000 cases. The chance of complication during surgery or the morbidity rate is a little higher, around <.007% (See OPTN).
It seems that this 'minor major' surgery is a relatively safe procedure. Living transplantations then might be a viable means to procuring more kidneys. The next post will then begin to look at the ethics surrounding living kidney procurement options – most specifically at direct financial incentive options.
Post Script
I want to thank my friend and blog-resident surgeon Jessica Clevenger for making sure I am not spoofing on any medical facts or jargon. Thank you.
Thursday, August 23, 2007
Selling Kidneys: Part I - Cadaveric Options
End-Stage Renal Disease (ESRD) has only two viable medical options to date: regular dialysis or kidney retransplantation. Dialysis is more expensive, less effective and limits certain lifestyles choices. Transplants, then, are a superior option to handling ESRD, but as it has already been said there is a severe shortage of kidneys. So three questions come to the fore: 1) What might increase the supply of kidneys? 2) Will that option be ethical? 3) Will that option be effective?
What might increase the supply of kidneys?
The good news is that there are a surprising number and a variety of ways to increase the number of transplantable kidneys. The bad news is that many of them are either questionably ethical or marginally effective or both.
One broad way to increase the kidney supply is to increase the number of cadaveric organ donations. Currently this country runs under an 'opt-in' system for cadaveric organ donation. In contrast Belgium, inter alia, runs on a 'opt-out' model, where everyone is presumed to be an organ donor unless they choose specifically and explicitly to not participate. Also, though no country is currently under a 'salvage' model it has been discussed by ethicists. Here citizen preference is completely disregarded - essentially the state has ownership of the body of deceased citizens for medical purposes: organ donation conscription. Of course, this final model has obvious ethical dilemmas.
There are two options with both ethical and effective promise.
1) Offer a 'required response' model. This is the blend between the 'opt-in' and 'opt-out' models. It would require citizens to make choice between being or not being an organ donor - most likely it would manifest as a question on yearly IRS tax forms. Polls have suggested that many people want or are willing to be organ donors, but have been deterred in the process to 'opt-in.' The hopes of this method would be to reduce the possible deterrence in becoming a organ donor, which is currently done through the DMV while registering/updating licenses. The downside of the model is that on its own it does introduce an incentive for donating.
2) The government offers a non-direct pecuniary incentive for those willing to be organ donors. This incentive could take many forms. Mostly likely it would be some type of premium reduction in the cost of health insurance (subsidized by the government or run through medicare), a one-time tax reduction, or subsidizing funeral costs. This would almost surely increase the number of donors, but there are ethical qualms about the introduction of any form of pecuniary incentives (this will be discussed at length - perhaps even ad nauseam - in future posts).
Both of these options are ethically innocuous enough to be at least conceivable options in the United States. However, the fact is they just won't be able to satiate the need for kidneys. (Though these measures should still be seriously considered because of the inability to do living transplantations on other organs, most poignantly hearts.
Even if some financial incentive is introduced to increase the number of citizens to enroll as organ donors it will not be able to adequately reduce the number of patients on the kidney waiting-list. Even if everyone was a donor there would likely still be need for kidneys because so few people die in a way compatible with donating.
So, while cadaveric options to increase the supply of organs may be a worthwhile venture, it will not be suitable to address the shortage for kidneys. That is why living kidney transplantations must be considered. In the next post I will address the medical issues surrounding living donation (LD) and what incentives might be introduced to increase such operations.
What might increase the supply of kidneys?
The good news is that there are a surprising number and a variety of ways to increase the number of transplantable kidneys. The bad news is that many of them are either questionably ethical or marginally effective or both.
One broad way to increase the kidney supply is to increase the number of cadaveric organ donations. Currently this country runs under an 'opt-in' system for cadaveric organ donation. In contrast Belgium, inter alia, runs on a 'opt-out' model, where everyone is presumed to be an organ donor unless they choose specifically and explicitly to not participate. Also, though no country is currently under a 'salvage' model it has been discussed by ethicists. Here citizen preference is completely disregarded - essentially the state has ownership of the body of deceased citizens for medical purposes: organ donation conscription. Of course, this final model has obvious ethical dilemmas.
There are two options with both ethical and effective promise.
1) Offer a 'required response' model. This is the blend between the 'opt-in' and 'opt-out' models. It would require citizens to make choice between being or not being an organ donor - most likely it would manifest as a question on yearly IRS tax forms. Polls have suggested that many people want or are willing to be organ donors, but have been deterred in the process to 'opt-in.' The hopes of this method would be to reduce the possible deterrence in becoming a organ donor, which is currently done through the DMV while registering/updating licenses. The downside of the model is that on its own it does introduce an incentive for donating.
2) The government offers a non-direct pecuniary incentive for those willing to be organ donors. This incentive could take many forms. Mostly likely it would be some type of premium reduction in the cost of health insurance (subsidized by the government or run through medicare), a one-time tax reduction, or subsidizing funeral costs. This would almost surely increase the number of donors, but there are ethical qualms about the introduction of any form of pecuniary incentives (this will be discussed at length - perhaps even ad nauseam - in future posts).
Both of these options are ethically innocuous enough to be at least conceivable options in the United States. However, the fact is they just won't be able to satiate the need for kidneys. (Though these measures should still be seriously considered because of the inability to do living transplantations on other organs, most poignantly hearts.
Even if some financial incentive is introduced to increase the number of citizens to enroll as organ donors it will not be able to adequately reduce the number of patients on the kidney waiting-list. Even if everyone was a donor there would likely still be need for kidneys because so few people die in a way compatible with donating.
So, while cadaveric options to increase the supply of organs may be a worthwhile venture, it will not be suitable to address the shortage for kidneys. That is why living kidney transplantations must be considered. In the next post I will address the medical issues surrounding living donation (LD) and what incentives might be introduced to increase such operations.
Sunday, August 19, 2007
Donating a Kidney: Part III
All is well. With the surgery behind me I can now look forward to the upcoming school year, which will be my twentieth year as a student (I have got to get a job).
Since last Tuesday I have been off medication, and my mobility has continued to increase daily. As you can see from the pictures below my incisions are quickly becoming scars. The two smaller incisions are exactly half an inch long and the exit incision is a little longer than three inches – the surgical doctor bragged before the surgery that she had very small hands.
After the leaving the hospital I haven’t heard from or anything about the recipient. Of course, Gift of Hope has my contact information and I could potentially be contacted at anytime; however, because I was always been ambivalent to meeting the recipient I am not disappointed.
In the next few weeks I am going to begin posting on why kidney markets are both viable and ethical means to addressing the acute shortage of kidneys. Much of research was done last year while I began to reflect on my decision to donate.
Since last Tuesday I have been off medication, and my mobility has continued to increase daily. As you can see from the pictures below my incisions are quickly becoming scars. The two smaller incisions are exactly half an inch long and the exit incision is a little longer than three inches – the surgical doctor bragged before the surgery that she had very small hands.
After the leaving the hospital I haven’t heard from or anything about the recipient. Of course, Gift of Hope has my contact information and I could potentially be contacted at anytime; however, because I was always been ambivalent to meeting the recipient I am not disappointed.
In the next few weeks I am going to begin posting on why kidney markets are both viable and ethical means to addressing the acute shortage of kidneys. Much of research was done last year while I began to reflect on my decision to donate.
Saturday, August 18, 2007
Family History
Students from Northwestern used to chant, “This is the place of the destitute, Garrett Biblical Institute!” Could our student loans prove otherwise? More recently and more kindly, the students of our sister institution would distinguish Garrett-Evangelical from Seabury as “Jesus Tech East” and “Jesus Tech West,” respectively. That Garrett and Northwestern are sister institutions to one another should be remembered. Like real family members their presence is sometimes forgotten, they blend into each others’ normalcy of life. Each takes the other for granted.
Though the Northwestern charter was established earlier, Garrett started classes a few months before. For a brief time the charter members even considered the name, Northwestern Biblical Institute – clearly they made for the better decision. For years the two schools shared students, faculty, and trustees, and many recognized Garrett as meeting the needs of Northwestern’s theological department, though this may not be the case today.
As all family members, each is in debt to the other. And, so, over the years each institution has helped the other. During the great depression Northwestern saved Garrett from financial insolvency. In 1933 Garrett foreclosed on its properties, and during that time Northwestern, unbeknownst to the trustees or president, secured the properties and resold them back to Garrett far below their value. After the ordeal an article in the Garrett Tower stated, “No words can ever quite acknowledge the debt which Garrett owes to Northwestern University for the part it played in this reorganization. In the darkest day of all, that institution threw its vast resources back of its sister school and prevented the educational home from falling into unfriendly hands…. Without that friend Garrett would probably be a homeless institution.” Certainly, there is more than geographic proximity that binds these two institutions, there is a shared story.
In the 20’s, either sadly, or appropriately, Northwestern changed its mascot from the Fighting Methodists to the Wildcats. Of course, it may be argued that a more rich rivalry between Notre Dame and Northwestern could have been preserved without such a change. And yet, do names matter? Sisters often take their husbands’ names, but the familial relationship isn’t lost. Garrett, too, has changed its name over the years, and still its essence is preserved.
There is no political message hidden in this article, no impetus for action, only a gentle reminder that human memory is brief and institutional memory even more so. As there is always a value in reveling in the nostalgia of the family history, so too is it for the shared story of these two great institutions. Perhaps students from both schools would gain from recognizing the contributions of each to the other.
Though the Northwestern charter was established earlier, Garrett started classes a few months before. For a brief time the charter members even considered the name, Northwestern Biblical Institute – clearly they made for the better decision. For years the two schools shared students, faculty, and trustees, and many recognized Garrett as meeting the needs of Northwestern’s theological department, though this may not be the case today.
As all family members, each is in debt to the other. And, so, over the years each institution has helped the other. During the great depression Northwestern saved Garrett from financial insolvency. In 1933 Garrett foreclosed on its properties, and during that time Northwestern, unbeknownst to the trustees or president, secured the properties and resold them back to Garrett far below their value. After the ordeal an article in the Garrett Tower stated, “No words can ever quite acknowledge the debt which Garrett owes to Northwestern University for the part it played in this reorganization. In the darkest day of all, that institution threw its vast resources back of its sister school and prevented the educational home from falling into unfriendly hands…. Without that friend Garrett would probably be a homeless institution.” Certainly, there is more than geographic proximity that binds these two institutions, there is a shared story.
In the 20’s, either sadly, or appropriately, Northwestern changed its mascot from the Fighting Methodists to the Wildcats. Of course, it may be argued that a more rich rivalry between Notre Dame and Northwestern could have been preserved without such a change. And yet, do names matter? Sisters often take their husbands’ names, but the familial relationship isn’t lost. Garrett, too, has changed its name over the years, and still its essence is preserved.
There is no political message hidden in this article, no impetus for action, only a gentle reminder that human memory is brief and institutional memory even more so. As there is always a value in reveling in the nostalgia of the family history, so too is it for the shared story of these two great institutions. Perhaps students from both schools would gain from recognizing the contributions of each to the other.
Where Have All the Crosses Gone
I have jokingly referred to myself, on account of my persistent lack of faith, as the only Calvinist who is not part of the elect. This comment is quite innocuous coming from a greenhorn theologian like myself, however, I have recently been privy to a number of disturbing theological comments made by Garrett-Evangelical staff and faculty. Future seminarians beware.
Perhaps the most harmless statement occurred today. I asked a Biblical Studies professor to explain why I missed an entire letter grade on an essay question. Their response, “It was too theological.” I rejoined, “Isn’t good biblical studies ultimately good theology?” A pause, then the professors response, “Not in this class, I’m looking only for the context.” Harnack seems to have won the day, and the historical critical method lives on.
The second incident happened during light conversation with another faculty member a few days ago. While discussing a range of topics the professor jovially remarked that for him, the word “orthodoxy” is pejorative. His comment was made without malice, but struck me odd for a professor working in a seminary. Are there not Religious Studies departments for such minded professors?
The final was by far the most disturbing. A group of students recently wanted to display a cross in each classroom. The students presented the issue to one of the higher administrators at Garrett-Evangelical. The administrator showed great reluctance toward the idea, because, as was quoted back to me, “Some see it as a symbol of torture.” The predominant symbol of the Christian faith might offend people in the confines and corridors of a Christian seminary? Is Christianity so susceptible to Foucaultian deconstructionism that renders all action into inevitable power plays? How can one not witness if one cannot point back to the cross? And perhaps most importantly, as a good friend of mine offered, isn’t the cross ultimately an ironic symbol. Original a symbol of Roman oppression and torture, that through Christ was then appropriated as a sign of resurrection and eternal forgiveness? To see the cross as a symbol of torture is to stop reading the gospels at the dereliction of the cross.
Paula Cole wrote an unfortunate song entitled, “Where Have the Cowboys Gone?” This one hit wonder, inspires me to muse, where have all the crosses gone? Some seminarians should be downright furious and dumbfounded at such developments. And I would even suggest, take appropriate action.
Mormons in the House
I have just finished reading the my seminary President's message that the school chapel will now temporarily house a congregation of LDS. Confused is too weak a word.
Personally, I am all for ecumenicalism... however, is this more accurately an interfaith situation? Comparing the Mormons to Baptists and Methodists is a stretch, no?
I am skeptical to this new development. However, I hope to hear opinions that will illuminate my reasoning. Yet, in the light of the fact that crosses might offend people, how is this any different? Opinions? Discuss
Personally, I am all for ecumenicalism... however, is this more accurately an interfaith situation? Comparing the Mormons to Baptists and Methodists is a stretch, no?
I am skeptical to this new development. However, I hope to hear opinions that will illuminate my reasoning. Yet, in the light of the fact that crosses might offend people, how is this any different? Opinions? Discuss
Rooting for Religion
In Chicago it is not uncommon to see a Cubs fans clad in blue, white and red appareal screaming anathemas toward a White Sox fan. Within workplaces across Chicago this rivalry continues; co-workers mock one another for their misplaced allegiances. To suggest that both are essentially baseball franchise teams that have little difference except logo, roster, and stadium would be blasphemy. To be a White Sox fan is categorically different than being a Cubs fan, each would assert. It would surely be suggested that if you didn’t see a difference between the teams you necessarily couldn’t be a fan of either. And all of this sports hoopla and franchise worshiping is pretty common practice.
So, why can’t someone rout with the same fervor for their religion as they do for their baseball team?
This brings us to the Catholic Church. On July 7th Pope Benedict XVI authorized the use of Latin services. However, it is not the lingua franca issue that caused concern. Instead, the Jewish Anti-Defamation League protested the also reinstated Good Friday prayer calling for the conversion of Jews.
On July 10, the Pope restated language in a document issued in 2000 that essentially proclaimed the primacy of the Catholic Church and it the sole salvific mediator.
On Friday, the Cubs will be playing at home against Houston with nearly 40,000 loyal fans in attendance. All of them will be sharing two beliefs: More Cubs fans are good, and the Cubs are the best baseball team ever.
The Pope was merely suggesting a similar sentiment for his Church: More Catholics are good, and the Catholic Church is the best religion ever.
So what is so surprisingly about such developments?
Cubs and Sox fans would never agree to disagree as to which team is the best. It would be disloyal even to suggest another perspective was possible. So why can't one share the same fervor for their religion?
So, why can’t someone rout with the same fervor for their religion as they do for their baseball team?
This brings us to the Catholic Church. On July 7th Pope Benedict XVI authorized the use of Latin services. However, it is not the lingua franca issue that caused concern. Instead, the Jewish Anti-Defamation League protested the also reinstated Good Friday prayer calling for the conversion of Jews.
On July 10, the Pope restated language in a document issued in 2000 that essentially proclaimed the primacy of the Catholic Church and it the sole salvific mediator.
On Friday, the Cubs will be playing at home against Houston with nearly 40,000 loyal fans in attendance. All of them will be sharing two beliefs: More Cubs fans are good, and the Cubs are the best baseball team ever.
The Pope was merely suggesting a similar sentiment for his Church: More Catholics are good, and the Catholic Church is the best religion ever.
So what is so surprisingly about such developments?
Cubs and Sox fans would never agree to disagree as to which team is the best. It would be disloyal even to suggest another perspective was possible. So why can't one share the same fervor for their religion?
Donating a Kidney: Part II
Two days ago my kidney was removed. Two hours after it was removed it began to filter blood and produce urine for a fifty-year old man who I have never met. We live in strange times.
My first post stated that my surgery was for Friday, but unexpected cadaveric donations came up and pushed my operations to Tuesday. Of course, one should be happy that more transplants took place and at the same time, cadaveric donations also inevitably signal death. A mixed of macabre and miracle; something thoroughly Christian in it all, too.
Of course the change in the surgery wasn’t a problem for me, because I had already taken two weeks off from work for recovery, but it meant my girlfriend Amanda would not be able to stay with me during my overnight stay at the hospital after the surgery. If I rescheduled I wouldn’t have time to heal before school started so the date was set for Tuesday, August 7, 2007.
The day before the surgery Amanda and I had a quiet day reading and cooking. I felt little stress, and was looking forward to my operation. In the evening I stopped eating solids and at midnight I stopped drinking liquids. It stormed most of the night, and though ominous I felt at peace with my decision. I awoke at 3:30 in the morning not being able to sleep any longer. At 4:30 we took showers, dried and dressed. We left at 5:15 and arrived at the Surgery Reception Desk at 6:00.
After signing a few medical forms I was escorted, with Amanda, to a pre-op room. There I was asked to exchange my clothes and bracelet (that I never take off) for a flimsy gown that made me feel pasty, weak, and emaciated. While I changed Amanda, who is a nurse, looked innocently at my medical records, and accidentally found that the recipient’s name, age, and gender. Later, she would tell me that she saw his family in the waiting room, being told that the retransplantation would begin.
Back in the pre-op room there was thirty minutes of doctors, nurses and attendants who kept asking the same ten or twenty questions; What is your name? Any medical allergies (yes, Keflex), Who are you donating you kidney to? Every time I answered the question by stating that I was a non-direct donor they would respond, “Oh, how, um, generous.” Then I was given an IV line and kissed Amanda goodbye. During the entirety of the procedure I felt qualm, sure about my decision, happy that my year of contemplation was coming to fruition. The last thing I remember was entering the machine-laden operation room and placed on the table, being strapped down and then… …
I awoke peacefully. There was almost no pain. The recovery room was loud and I sensed it was large though I couldn’t tell because of the curtains that surrounded me. My nurse, Kim was talked with in bursts of sentences; “How are you? Doing well? I am giving you a pain medication. You will get a private room soon.” Then I was alone. In front of me was a nurses’ station, and I continually and groggily kept smiling and waving at nurses and passers-by. Finally, Amanda came back to the recovery room. I proudly, if not dumbly, lifted my gown aside to show her three incisions. The larger one cut across my lower abdomen and was no less than five inches. My surgeon; doctor Baker came in to tell me that the operation went well. My kidney’s renal artery was naturally split in two (which isn’t uncommon) and she had needed to do some work to splice into one, but that that too had been successful.
A new nurse took over for Kim, her name was Faye. She had just been married in Israel, and through honed skills of deduction I surmised she was Jewish. We talked about Jews weddings, which after seeing one at the age of fourteen always found preferable to protestant, though not Catholic weddings. After arriving in recovery at around 10:00, I finally was wheeled to my hospital room at around 2:00 p.m. Still groggy, and beginning to feel some pain, I made a number of calls to family and friends to inform them that I was still alive.
In the early evening I began to reel. My friend Krista came to visit – bless her heart; and by bringing me flowers concurrently took a personal stand against gender stereotyping. Yet, as the anesthesia began to wear off I felt discomfort and pain. The anesthesia led to dry-mouth and nausea, and Krista had to watch me reject a lovely serving of apple-juice and Jell-O (She’s quite a good friend). That evening I had to ask for more pain medication because I couldn’t fall asleep. Around 4:00 a.m. I finally was able to rest.
The next day another friend, Ted, came to visit and by 1:00 in the afternoon I had taken a shower, eaten and was urinating normally. These were three goals before being discharged, and soon I was being driven to Indiana by my brother John. After arriving at Amanda’s house I promptly fell to sleep.
Today I have taken things slowly, as I shall do for the next three to four days. On Monday I have a check up, and will return to work on Tuesday if I continue to improve as expected. Ultimately, the experience was a positive one. In economics they call these types of transactions Pareto-efficient, meaning that all parties ended better off than how they started. Perhaps the old adage is true: It is better to give than to receive.
My first post stated that my surgery was for Friday, but unexpected cadaveric donations came up and pushed my operations to Tuesday. Of course, one should be happy that more transplants took place and at the same time, cadaveric donations also inevitably signal death. A mixed of macabre and miracle; something thoroughly Christian in it all, too.
Of course the change in the surgery wasn’t a problem for me, because I had already taken two weeks off from work for recovery, but it meant my girlfriend Amanda would not be able to stay with me during my overnight stay at the hospital after the surgery. If I rescheduled I wouldn’t have time to heal before school started so the date was set for Tuesday, August 7, 2007.
The day before the surgery Amanda and I had a quiet day reading and cooking. I felt little stress, and was looking forward to my operation. In the evening I stopped eating solids and at midnight I stopped drinking liquids. It stormed most of the night, and though ominous I felt at peace with my decision. I awoke at 3:30 in the morning not being able to sleep any longer. At 4:30 we took showers, dried and dressed. We left at 5:15 and arrived at the Surgery Reception Desk at 6:00.
After signing a few medical forms I was escorted, with Amanda, to a pre-op room. There I was asked to exchange my clothes and bracelet (that I never take off) for a flimsy gown that made me feel pasty, weak, and emaciated. While I changed Amanda, who is a nurse, looked innocently at my medical records, and accidentally found that the recipient’s name, age, and gender. Later, she would tell me that she saw his family in the waiting room, being told that the retransplantation would begin.
Back in the pre-op room there was thirty minutes of doctors, nurses and attendants who kept asking the same ten or twenty questions; What is your name? Any medical allergies (yes, Keflex), Who are you donating you kidney to? Every time I answered the question by stating that I was a non-direct donor they would respond, “Oh, how, um, generous.” Then I was given an IV line and kissed Amanda goodbye. During the entirety of the procedure I felt qualm, sure about my decision, happy that my year of contemplation was coming to fruition. The last thing I remember was entering the machine-laden operation room and placed on the table, being strapped down and then… …
I awoke peacefully. There was almost no pain. The recovery room was loud and I sensed it was large though I couldn’t tell because of the curtains that surrounded me. My nurse, Kim was talked with in bursts of sentences; “How are you? Doing well? I am giving you a pain medication. You will get a private room soon.” Then I was alone. In front of me was a nurses’ station, and I continually and groggily kept smiling and waving at nurses and passers-by. Finally, Amanda came back to the recovery room. I proudly, if not dumbly, lifted my gown aside to show her three incisions. The larger one cut across my lower abdomen and was no less than five inches. My surgeon; doctor Baker came in to tell me that the operation went well. My kidney’s renal artery was naturally split in two (which isn’t uncommon) and she had needed to do some work to splice into one, but that that too had been successful.
A new nurse took over for Kim, her name was Faye. She had just been married in Israel, and through honed skills of deduction I surmised she was Jewish. We talked about Jews weddings, which after seeing one at the age of fourteen always found preferable to protestant, though not Catholic weddings. After arriving in recovery at around 10:00, I finally was wheeled to my hospital room at around 2:00 p.m. Still groggy, and beginning to feel some pain, I made a number of calls to family and friends to inform them that I was still alive.
In the early evening I began to reel. My friend Krista came to visit – bless her heart; and by bringing me flowers concurrently took a personal stand against gender stereotyping. Yet, as the anesthesia began to wear off I felt discomfort and pain. The anesthesia led to dry-mouth and nausea, and Krista had to watch me reject a lovely serving of apple-juice and Jell-O (She’s quite a good friend). That evening I had to ask for more pain medication because I couldn’t fall asleep. Around 4:00 a.m. I finally was able to rest.
The next day another friend, Ted, came to visit and by 1:00 in the afternoon I had taken a shower, eaten and was urinating normally. These were three goals before being discharged, and soon I was being driven to Indiana by my brother John. After arriving at Amanda’s house I promptly fell to sleep.
Today I have taken things slowly, as I shall do for the next three to four days. On Monday I have a check up, and will return to work on Tuesday if I continue to improve as expected. Ultimately, the experience was a positive one. In economics they call these types of transactions Pareto-efficient, meaning that all parties ended better off than how they started. Perhaps the old adage is true: It is better to give than to receive.
Donating a Kidney: Part I
If you do yet not know I am donating a kidney. The surgery is this Friday.
This decision was borne from the brain-child of one Maryanna Ramirez (Maryanna, consequently, is the type of friend one thanks their lucky stars for: beside her infinite ability to forgive she has impeccable taste and a long history of promising and datable roommates). Maryanna almost a year ago mentioned that in the medical field there are ethical debates surrounding the permissibility of organ markets. She mentioned that genesis of such medical ethics came from a book by Richard Titmuss entitled, "The Gift Relationship." She also mentioned Sally Satel who currently write for the American Enterprise Institute and has written in favor of organ markets – specifically (if not exclusively) kidney markets.
Thus was my introduction to the world of kidneys. Now, Maryanna knew such an issue would fascinate me for three reasons: 1) it involved economics 2) it involved ethics 3) it was a generally contentious subject.
In the following weeks I read not only the Titmuss and Satel pieces, but everything else on living laparoscopic nephrectomies, which is the medical operation kidney donors undergo. After my initial foray into the world of organ donation two things became abundantly clear: there was a shortage of kidneys and I could relatively safely donate one of my kidneys.
First, lets talk about the shortage of kidneys. End-Stage Renal Disease (ESRD) is a catch-all medical condition for kidneys that are failing or not functioning to such an extant that dialysis or transplantation are necessary. Though cadaveric donation and living relative donations meet much of the demand for kidney transplantations about 4,000 kidneys annually are still needed. Dialysis is the only option for those waiting on the list or who have no option of being a recipient. Further, dialysis – though a wonderful medical invention – marketedly decreases life expectancy, quality of life, and in the long run costs more, on average, than transplantation. The number of ESRD patients who annually die waiting for a kidney is nearly the same as the number of US military deaths in Iraq in the past four years – around 3,600.
Second, a living laparoscopic nephrectomy is a relatively safe procedure. Besides the chance of death being effectively 0%, complications are exceedingly rare. The two hour long procedure consists of two half-inch incisions (for laparoscope and surgical tool) and one four to five inch incision (for kidney removal). Most post-operative pain is not due to the incision, but rather the carbon-dioxide gas used during the operation to literally inflate the chest cavity. A donor stays over night and discharged the next day. In one to two weeks of rest donors can return to work (required it involves no heavy-lifting) and in four to five weeks donors can return to rigorous exercise.
For these two reasons I decided a year ago that I would donate my kidney. On Friday that promised decision will become a reality. Per a friend’s request that I blog the process I am going to do just that. Thus, I will be updating the process throughout the week, and would love to take questions you may have.
This decision was borne from the brain-child of one Maryanna Ramirez (Maryanna, consequently, is the type of friend one thanks their lucky stars for: beside her infinite ability to forgive she has impeccable taste and a long history of promising and datable roommates). Maryanna almost a year ago mentioned that in the medical field there are ethical debates surrounding the permissibility of organ markets. She mentioned that genesis of such medical ethics came from a book by Richard Titmuss entitled, "The Gift Relationship." She also mentioned Sally Satel who currently write for the American Enterprise Institute and has written in favor of organ markets – specifically (if not exclusively) kidney markets.
Thus was my introduction to the world of kidneys. Now, Maryanna knew such an issue would fascinate me for three reasons: 1) it involved economics 2) it involved ethics 3) it was a generally contentious subject.
In the following weeks I read not only the Titmuss and Satel pieces, but everything else on living laparoscopic nephrectomies, which is the medical operation kidney donors undergo. After my initial foray into the world of organ donation two things became abundantly clear: there was a shortage of kidneys and I could relatively safely donate one of my kidneys.
First, lets talk about the shortage of kidneys. End-Stage Renal Disease (ESRD) is a catch-all medical condition for kidneys that are failing or not functioning to such an extant that dialysis or transplantation are necessary. Though cadaveric donation and living relative donations meet much of the demand for kidney transplantations about 4,000 kidneys annually are still needed. Dialysis is the only option for those waiting on the list or who have no option of being a recipient. Further, dialysis – though a wonderful medical invention – marketedly decreases life expectancy, quality of life, and in the long run costs more, on average, than transplantation. The number of ESRD patients who annually die waiting for a kidney is nearly the same as the number of US military deaths in Iraq in the past four years – around 3,600.
Second, a living laparoscopic nephrectomy is a relatively safe procedure. Besides the chance of death being effectively 0%, complications are exceedingly rare. The two hour long procedure consists of two half-inch incisions (for laparoscope and surgical tool) and one four to five inch incision (for kidney removal). Most post-operative pain is not due to the incision, but rather the carbon-dioxide gas used during the operation to literally inflate the chest cavity. A donor stays over night and discharged the next day. In one to two weeks of rest donors can return to work (required it involves no heavy-lifting) and in four to five weeks donors can return to rigorous exercise.
For these two reasons I decided a year ago that I would donate my kidney. On Friday that promised decision will become a reality. Per a friend’s request that I blog the process I am going to do just that. Thus, I will be updating the process throughout the week, and would love to take questions you may have.
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