Too Old to Donate?
Editor's note: Joan Bakewell presents Inside The Ethics Committee and writes here about the second programme in the current series - GS.
Joan Bakewell writes:
This is a story close to my heart...and other organs.
I've carried a donor card for years now, in readiness for that fatal car accident when my body parts can be whisked away to make other lives better.
Happily for me that has not happened. Now I learn that some individuals are deciding to make a gift of a kidney while they are still alive... and to a complete stranger.
In recent years the need for kidneys has increased but the usual sources have been drying up.
For one thing there are fewer of those dangerous road accidents. There has been medical progress too.
So it's quite common these days for people to donate a living kidney to one of their own family or someone close to them.
But over a hundred people have now given for entirely altruistic reasons to someone they know nothing about. What selfless generosity!
That's how I came to know about Pamela: she's a feisty Scot who had nursed her dying husband and knew the agonies he went through as his kidneys failed.
After his death she decided to offer one of her own kidneys to anyone who was in need. She made an appointment with a kidney specialist. And that's when her problems started. Pamela is 82 years old.
Inside the Ethics Committee explores the issues that Pamela's offer presents for her, the transplant team and a possible recipient.
A lot of talking goes on with transplant operations and in Pamela's case it was very thorough. Kidney function declines with the years.
Had she considered what it would mean to be left with only one kidney at her age? Would her aging kidney be good enough for someone to receive?
Pamela stuck to her guns. She was resolute about making this gift. She saw it as a challenge in which she had to overcome every hurdle the transplant team put in her way.
She not only had to undergo the barrage of tests routinely performed to assess a person's suitability. She also had to pass a whole lot more to test her own resilience and fitness. Would she be strong enough to deal with the operation on her own body?
Speaking personally, I suspect the team initially had the sort of response our society usually reserves for the old. Many of us are living much longer - there are some ten million people over 65 - but we are expected to be unobtrusive, mild and agreeable. And, if possible, to stay healthy.
Pamela was defying all the norms and vindicating for us all the right to our own intentions.
Until recently such an offer as hers would have been rejected out of hand. Only in 2006 did the Human Tissue Act, passed in 2004, make donating a living kidney to a stranger possible.
Such a kidney is usually allocated according to the same criteria as from a deceased donor. But in Pamela's case the transplant team had to consider whether it was appropriate for an old kidney to go to a young recipient. How would such a person feel about that?
Dialysis is a grim procedure. Hospitals make it as congenial as possible but there's no denying that usually you are routinely latched for three hours to a lumbering machine. Surely there would plenty of candidates to receive Pamela's kidney.
Inside the Ethics Committee follows the story with Pamela and her doctors. And we also draw on the knowledge and opinions of experts to guide us through the tangle of ethical considerations.
It's a real cliff hanger.Joan Bakewell presents Inside The Ethics Committee on Radio 4. Too Old to Donate? is broadcast on Thursday 26 July at 09:00.