Do unto others

Are your kidneys available to me? - Eleventh in a series

We’re tackling a number of questions that Christians should ask about live kidney donation.

Some were posed at the end of the fifth post of this series, and we have not yet addressed three of them:

  • How would changing our laws to permit payment for human organs affect our society?
  • Would payment for organs be supported or opposed in Christian doctrine?
  • What types of questions in the Christian life are bonafide matters for individual conscience?

And in the previous post, we ended with this question:

  • In some cases, would God approve of live kidney donation?

If as Christians we determine that live kidney donation is contrary to God’s perfect will for our lives in every case, then we do not need to wonder if payment for organs would be OK with God. We could study how that might affect our society, but only from a negative perspective.

Perhaps we can never agree on what the bonafide issues for individual conscience are, but could kick off a great debate.

So, can God ever approve of live kidney donation? God does permit it, but that does not signify it is his perfect will. With many things, he allows us to proceed, though we are walking in our own way. A theological discussion of that is here, which spotlights this Scripture: Do not be conformed to this present world, but be transformed by the renewing of your mind, so that you may test and approve what is the will of God-what is good and well-pleasing and perfect (Romans 12:2).

How does one renew his mind? Reading the Bible, prayer, Christian fellowship, church attendance, keeping the Sabbath to rest and worship; all these play a role. Perhaps you could add to this list in the comments section.

It is still possible that Christians doing all these things will arrive at different conclusions. We inch along in our walk with Christ, holding one viewpoint at a certain stage in our spiritual growth, and changing later on.

Christians are not a monolith, but a mosaic, living stones being built up into a spiritual house. (1Pe 2:5) Such work takes long suffering.

Wonderful, sincere physicians and scientists have been and are involved in seeking ways to improve the quality of life through organ transplantation. How could anyone fault them for their natural curiosity and diligent labor to find ways to make transplantation successful? Why would anyone do that?

A surgical operation at Royal Liverpool University Hospital. Wellcome L0029417.jpg
By http://wellcomeimages.org/indexplus/obf_images/be/07/ae498371cfd18c7f616d656b28d2.jpg Gallery: http://wellcomeimages.org/indexplus/image/L0029417.html, CC BY 4.0, Link

Perhaps the answer is: life extension for the recipient should not outweigh consideration of risks for the donor. We know there are risks and consequences for the donor, so the question becomes: Is risking one’s health and life to possibly save or improve a human life what God would want a person to do?

We have looked at the various risks to this procedure, and a related question is: What are the chances or probabilities of incurring these risks? It is stated on various websites: The risk of problems from surgery is less than 5%, that is 1 in 20 donors, and the risk of death is 1 in 3000 donors, less than 1%. (ref) However, as brought out on Livingdonor101.com, the actual statistics are unknown:

We have NO comprehensive data on living donor health and well-being. The Secretary of health mandated one year of follow-up on all living donors in 2000, but the centers have been so noncompliant that a 2009 report said the database was woefully incomplete and useless for research or analysis. In 2013, OPTN admitted that 35% of LKDs were reported "lost" to follow-up with no indication contact was attempted….
According to OPTN, 4.4 living kidney donors die every year in the US within 12 months of donating. AND 20% of living kidney donors experience complications. Some require surgical intervention and/or lifelong maintenance. (ref)

So, first a prospective donor must choose whose data to believe. Or, we could ask, is it right for a donor to accept any level of risk? It is a certainty that the person who donates a kidney is taking a risk with his own health and future quality of life. Each one would know how this may affect those close to him.

Is this comparable to a civilian entering the military or police force? He or she knows that in duty there is risk of injury or death, yet they agree to this, ideally because they desire to protect the national interests of the USA and to preserve our country. Likewise, the living donor realizes there are risks, but desires to preserve or lengthen the life of the recipient.

We know that people feel called to serve in the military, but what about there being a call to donate a kidney? Could a Christian hear a call from God to donate a kidney? Perhaps only the person who has actually experienced the situation could answer this.

Analogies can confuse rather than clarify. The Military is not analogous to the Medical Profession. To conflate the two through clever comparisons will be a big waste of time. Suffice to say, our world is set up so that a military or police commander has the right to send his underlings into the fray, but a doctor is not empowered nor trained to send his patient into harm’s way unless to restore his health such as through radiation therapy. Though in extreme cases, as a last ditch measure, new therapies may be tried to save a life that instead end it, as a rule, doctors do not take risks with their patients’ lives.

On the websites encouraging live kidney donation, we see this question: What are the risks and benefits?

What are the benefits? The only benefit is the happy feeling that one has helped another to have a better quality of life. (ref) On the Living Kidney Donors Network, ALL of the benefits noted apply to the recipient! (ref) On the Johns Hopkins Medicine site we are told: There are many benefits to becoming a living donor. One of the most obvious benefits is that you can save a life, or drastically improve the quality of life for the recipient. The only other benefit listed is: Many living donors experience positive feelings of life and joy. (ref) Those are not MANY benefits.

If a doctor were to advise a patient to donate a kidney, then he is suggesting that he should take a risk with his health. He is not adhering to the Hippocratic Oath to “Do no harm” nor the Christian ethic to “Do unto others…”.

And what about the donor: Isn’t the donor doing unto others as he would have them to do to him?

If that is his motivation, then he hopes others would risk their health to help him out in a dire need which is not a Christian ethic. Is he not, rather, bypassing the Golden Rule to achieve a good work that he could not advise others to do?

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Friends do let friends donate?

Are your kidneys available to me? - Tenth in a series

If you had a son or daughter or parent who decided to donate a kidney, would you want to offer them any advice or assistance? If a person were sincerely convinced it would be right and good to donate, what influence could you have? Yet if anything were to go wrong, it could affect your life and others in your family significantly.

If our churches taught on biomedical topics that touch on the sanctity of life, we could become aware of potential risks and any ungodly aspects they pose, despite being endorsed by our culture — and many churches.

If people could reflect on these matters before becoming emotionally involved in real life situations, they would stand a good chance of making a decision based on Scripture and obedience to God, not on emotion and yes, ignorance of facts.

Hmm, this is beginning to sound like an “if” piece.

Kipling’s If comes to mind:

If you can keep your head when all about you
       Are losing theirs and blaming it on you,
If you can trust yourself when all men doubt you,
       But make allowance for their doubting too;…

Can we Christians keep our heads in a society where others are emphasizing progress through science, while pursuing answers ourselves in the same venues, but putting first God’s kingdom and righteousness?

It could help to study these things together. A sanctity of life Sunday school series could have a class on live kidney donation. What does God think about this? To begin, what are the risks to the body — that belongs to him? For you are not your own (1Co 6:19). Gathering information on this topic, we find the risks are downplayed on many websites. Examples:


The class could also observe transparency on some sites that are seeking living donors:

Unfortunately, some donors have lost their kidney function and require dialysis several years after donation. There is a priority system in place so that donors receive extra points for deceased donor kidney transplant when they are on the waiting list. (ref)

Maybe we would call that one the “The Big Give and Take”.

Another site explains

Your emotions when you donate a kidney
Kidney donors may have a wide range of emotions, including joy, relief, anxiety or a sense of loss throughout the process. Even if you are elated at the thought of giving the gift of life, as a potential kidney donor you should have a support system throughout the process. Family, friends, spiritual guidance, organized support groups and mental health counseling can be helpful.
Getting a nephrectomy done
There are two methods to remove a kidney: an open nephrectomy and a laparoscopic nephrectomy.
In an open nephrectomy, an incision approximately 12 inches long is made in the abdomen. Sometimes the surgeon must remove a rib. The ureter (the tube that carries urine from the kidney to the bladder) is cut between the bladder and the kidney, and blood vessels are cut and clamped before the kidney is removed. The incision is closed with stitches or staples. The procedure can take up to three hours. Some benefits of open nephrectomy include:
    - Allowing surgeons to place sterile ice directly on the kidney to prevent damage during surgery
    - Donors experience less urinary leakage after surgery…(ref)

After studying these facts, what discussion might follow?

An excellent website to include would be LivingDonor101.com, which shares information on risks without asking anything in return except a donation to help them host their site. It describes the physical and some psychosocial risks for living kidney donors such as: Adrenal Insufficiency/Addison's Disease, Bleeding, Cardiac/Heart issues, Chylous Ascites (lymph gland related), Chronic Pain, Insurance and Financial issues, Gastrointestinal issues, Hernia, Hypertension, Infection, Kidney Failure, Chronic Kidney Disease, End-Stage Renal Disease, Martial/Relationship Conflict, Nerve Damage, others.

Another site, OrganFacts.net, offers lots of information on organ donation with a spotlight on whether the “brain dead” donor is actually dead.

A prospective donor might start to wonder: How will my living donation affect my family and friends? Do I have the right to expose them to potential time-consuming difficulties on my behalf? If I do not recuperate fully, can I/my family afford it? Would I ask others to donate their kidney for me? What has been the cause of the recipient’s need? If through self abuse, would that pattern continue and my gift not be appreciated?

Nevertheless, in some cases, would God approve of live kidney donation?

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Angel fish
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...and every living creature that moveth, which the waters brought forth abundantly, after their kind, and every winged fowl after his kind ... the living creature after his kind, cattle, and creeping thing, and beast of the earth after his kind ...the beast of the earth after his kind, and cattle after their kind, and every thing that creepeth upon the earth after his kind: and God saw that it was good. -Genesis 1

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A SistersSite eBook

Flesh and Bone and The Protestant Conscience is an e-book on Amazon.com. It is 99¢ and in the Amazon lending library as well. It is also available here in PDF format. The book description follows.

Would you let your conscience be your guide?

Does God care if the skin and bone of the dead are passed along to the living for medical uses? Is organ donation OK with God? Should you sign a Living Will?

Did you know that dead organ donors are often anesthetized before their organs are removed? Do you know the current definition of death? The conscience cannot function without facts.

As we ponder the ethics of in vitro fertilization, stem cell research and man-made chimeras, our thoughts trail off. How then should we live? (Ez 33:10)

How should a Christian think about euthanasia by starvation when doctors and the state attorney general all agree it is time to withhold feeding from a brain injured patient? Some things are family matters, but someday it may be our family.

Here is a small book to help you think about whether you want to sign your driver's license, donate a kidney, cremate your loved one, and many other practical questions that may arise in the course of your healthcare decisions or watch over others.

It offers a special focus on the doctrine of the Resurrection that is related to such decisions. Sunday School classes and Bible Study groups could use this book to facilitate discussion about the issues covered.