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Inside The Ethics Committee: Too Old to Donate?

Wednesday 25 July 2012, 17:12

Greg Smith Greg Smith

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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.

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  • rate this

    Comment number 1.

    What an amazing woman, and an amazing expression of her own loss. A beautiful piece of reflection...

  • rate this

    Comment number 2.

    I am currently going through the tests to donate a kidney - I'm almost 64. I would love to be able to contact Pamela to chat with her... wonder if this is possible?

  • rate this

    Comment number 3.

    I am certainly a supporter of all Pamelas, having received a kidney from a 72 year old (deceased) donor when I was 45. What was unclear to me was why the doctors on the programme were unhappy about giving an old kidney to a young receipient. My consultant's view was that once people had passed the hard living bit of their life and were past 40 their kidney was as good as as any youngsters. That didn't apply to mine as it came from a teetotal lay preacher. It got a shock when it found that I liked my scotch, but is still going strong 20 years on.

  • rate this

    Comment number 4.

    I was a contemporary of Joan Bakewell at Cambridge and listened intently to her programme this morning on ethical decisions in the context of kidney donations.
    It was the result of hearing a Radio 4 Today programme in February featuring an altruistic kidney donor which started me thinking about doing something really worthwhile in my eighties.
    I've been advancing through the assessment stages and so far seem to be a suitable donor. I have no relatives to be concerned about the operation and I am not concerned either.
    I've had a good, long and happy life and wish to go on living with as many as possible of my faculties in reasonable working order, buoyed-up by the thought that I may have contributed to some other older person's health and, I trust, happiness

  • rate this

    Comment number 5.

    RE:– transplanting aged kidneys.

    How quickly we forget. In the 1970s/80s a group at the Royal postgraduate medical School under Prof Richard Batchelor showed that transference of an "old" rat kidney to a young animal could be carried on through many generations so that the transplanted kidney "lived" for many, many years longer than the lifespan of an animal. Transplantation appeared to rejuvenate the kidney.

    Go for it, I hope I will make the same decision when "my time" comes closer.

  • rate this

    Comment number 6.

    What a wonderful woman is Pamela who has made headway and headlines for the continuing value of older people in medicine and society. We need more Pamelas and more publicity for them. I am 70 and now too old to give blood which I think is nonsense. I am very fit and gave blood regularly until recently. I am still fit and active and can do at least 10 miles hill walking as do many of my older friends. We are always told that there is a shortage of blood donors for which I blame the age restriction and the 50 kilo minimum weight restriction. When I was young, there was no weight restriction for donating blood and at about 46 kilos I suffered no ill effects. Please can we have a little common sense; let older people be givers in society and not just burdens on the taxpayer.

  • rate this

    Comment number 7.

    Anyone who is interested in altruistic kidney donation should look at the personal video stories of 23 people who have donated a kidney altruistically. The videos are on the website of the "Give a Kidney - one's enough" charity: http://www.giveakidney.org/category/personal-stories/donors/

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