Some chooch named Lawrence Henry wrote a psychotic attack piece on me in The American Spectator. I replied in an opposing piece. Both are copied below.
First, Mr. Henry:
http://www.spectator.org/dsp_article.asp?art_id=11790
An Update on Transplant
By Lawrence Henry
Published 7/27/2007 12:08:35 AM
In an op-ed published July 16 in the Chicago Tribune, "Using the Internet to Donate Organs," Tom Simon argued the case for donating a kidney to a stranger via the website Matchingdonors.com.
"When I made the choice to donate a kidney to a stranger, I began the process as a non-directed donor -- meaning I was prepared to let Northwestern Memorial Hospital choose my recipient for me. I immediately began to have misgivings about this approach.
"What if my kidney wound up inside a registered sex offender or a violent ex-convict....I was less interested in saving the sickest person I could find and more interested in saving the life of someone who could make a difference in the world once his or her health was restored to normal.
"...I found the posting of a Chicago woman named Brenda for whom I felt a great deal of empathy. She was young, aspired to have kids and worked as a domestic violence court victim advocate for the Cook County state's attorney's office."
TRANSLATION: I WANTED TO DONATE A KIDNEY TO A LIBERAL. Does this kind of sanctimony make you as nauseated as it makes me? I have been on the other side of this Internet tease. I did a one-week trial with Matchingdonors.com. I wrote to four people of my blood type who stated on the site that they were willing to donate to anyone. The site's internal messaging system confirmed that my messages had been read.
I heard from no one.
I don't know what Matchingdonors.com charges for the privilege of "playing God," as Mr. Simon so accurately puts it. But it costs about $700 for a "lifetime" membership for would-be recipients. I've been getting e-mail blandishments from the site ever since my trial membership. They have slick phone salespeople to try to persuade you to buy those "lifetime" memberships.
Here's the rub: If Mr. Simon and his like are "less interested in saving the sickest person I could find," that sickest person is left to die. Twenty percent of dialysis patients die every year. I've had one close call myself this year.
IN 1972, THE GOVERNMENT STRUCK A DEAL with private insurers. After three years of treatment, Medicare would take over insuring End Stage Renal Disease (ESRD) patients. That also qualifies most ESRD patients for Supplemental Security Income (SSI). Being in a weakened state, most of us take it.
As usual, the government had no idea what it was getting into. In its first full year of operation, the ESRD Medicare program was spending $229 million. By its tenth year, the program costs exceeded $2.5 billion. By 1997, that cost had ballooned to $15.64 billion. Most of this money goes toward maintaining dialysis patients. Transplant saves Medicare about 60 percent post-transplant, assuming a ten-year period, because, 36 months after getting a successful transplant, transplant recipients stop receiving Medicare payments. Transplant patients mostly return to normal lives (as I did for 20 years). Nearly two-thirds of dialysis patients, especially those with diabetes, find themselves unable to do any more than support their daily personal needs.
THIS IS A PUBLIC POLICY ISSUE, LIKE IT OR NOT. It makes sense for government to encourage transplant, as opposed to long-term dialysis, simply on the basis of cost outlay. But it also makes social sense, because transplant recipients lead transparently normal lives, working, paying taxes, raising families, contributing to the general welfare.
As always, faced with a system that doesn't work well, patients with the gumption have taken matters into their own hands -- and wallets. An old pal of mine, also going for his third kidney transplant, got in touch with me to urge me to solicit a kidney from my friends, church members, and associates. I did that, and ultimately found several willing donors. One survived the testing process, and was willing to donate to the swap program at my hospital. The database of potential paired transplant donations is being run now, and I should know within a couple of weeks whether or not I have a kidney.
The head doc of the transplant program here advised me to wait until the fall to see what the database turns up -- it changes regularly. If I don't have a kidney by that time, I will take a short trip to Tampa and register with a transplant center there. The waiting time for a cadaver transplant -- from accident victims, mostly -- is shorter in Florida than in the Northeast. I do not have to move to Tampa. I can simply be ready to hop a plane at a moment's notice. It's expensive, but lots cheaper than living the way I'm living now
PREFERABLY, TWO PROGRAMS OUGHT TO BE IMPLEMENTED. First, there ought to be a national program of reimbursal for "Good Samaritan" donors -- people willing to donate either to an individual or to a medical center's swap program. Put simply, you ought to be able to sell a kidney, or have yours heirs do so. Second, instead of asking people to designate themselves as organ donors through the driver's license programs of various states, it ought to flip over: People would be presumed donors unless they explicitly opt out.
This is called "presumed consent," and it exists in Portugal and Italy, where dialysis is minimal and transplant common. Unfortunately, an irreducible population of idiots in this country remains convinced that doctors wait, Frankenstein-like, scalpels at the ready, to turn an accident victim into a dugout canoe before he's really dead.
Ideally, both policies would work together. Presumed consent would tend to keep the otherwise-inflationary price for selling an organ down.
SO WHAT'S THE OBJECTION, IN THE MEANTIME, to Internet dating for organ donors? Several statistical realities.
Organ donations are matched up by blood type. As my doc told me, "The ABs cycle through very fast, because blood type is not an issue." An AB can receive a donation from anyone. Meantime, Bs, Os, and As wait, and are likely to be among the sickest cited by Tom Simon in his smarmy op-ed.
Internet matchups do little or nothing to even out regional inequities in waiting time. They do nothing much, at least intentionally, to alleviate the generalized, ill-distributed, suffering of the waiting population of transplant candidates. And they will tend to give kidneys, like Mr. Simon's, to those applicants who, naturally or by design, ring all the right Oprah-like bells to move Mr. Simon's and his cohort's questionable consciences.
Make no mistake, Good Samaritan donorship is in the wind these days. Transplant medical centers are filled with literature on the subject from the National Kidney Foundation, the very establishment of transplant.
It all helps. But it's still not enough.
Lawrence Henry writes every week from North Andover, Massachusetts.
---------------------------------------------------------
Here is my response:
In Defense of Matching Donors
By Tom Simon
As an FBI Special Agent with 12 years of service, mostly in the Counterterrorism field, imagine my surprise to log onto the American Spectator website and read Lawrence Henry’s weekly column calling me a smarmy, sanctimonious liberal of questionable conscience because of my decision to donate a kidney to a fellow law enforcement professional I met via the website Matchingdonors.com.
In his piece, Mr. Henry recounts his own negative experience with Matchingdonors.com that led him to the conclusion that donating a kidney via an internet-facilitated match is morally objectionable. I can’t help but wonder if his opinion would have been different had he achieved positive results after he spent his week begging strangers for a kidney on the web. Furthermore, I fail to see the moral distinction between Mr. Henry appealing publicly to strangers within his church congregation and my recipient, Brenda, making her appeal to a larger audience of strangers via the web.
The fact that Mr. Henry failed in his attempts to successfully procure a kidney via Matchingdonors.com should be no surprise as he only gave it a week’s worth of effort. Brenda’s profile remained on the site for two years before I stepped up to help. Part of that may have been due to her having one of those hard-to-match blood types Mr. Henry cited in his piece.
The other factor is that living “stranger” kidney donations are very rare. Less than 100 individuals in America will step forward this year to donate kidneys to complete strangers. During the three year history of Matchingdonors.com, the site has facilitated less than 50 kidney donations at a time where over 90,000 Americans await transplants. This tiny niche of the transplant field is hardly worth all this ethical hand-wringing when the number of lives being saved is relatively paltry.
I share Mr. Henry’s concerns with the expensive price tag associated with a lifetime membership to Matchingdonors.com. The site’s administrators (with whom I have no affiliation) informed me that they are a non-profit entity operating at a loss, yet they are committed to working with those in need by waiving fees or negotiating payment plans based upon the customer’s financial means. Personally, I think a better option would be for the United States to follow the lead of the Commonwealth of the Bahamas who recently inked a deal with Matchingdonors.com to put 100% of the country’s organ transplant waiting list on the site.
Mr. Henry is also right in his public policy analysis regarding the need to compensate living organ donors and switch to a “presumed consent” system for cadaver donors. Curing diabetes would also be a big help. However, his vitriol toward internet organ matching and those of us who’ve volunteered to help is misguided and more than a little bizarre.
The best argument in favor of Matchingdonors.com is Conservative to the core: it’s my kidney, and I’ll give it to whomever I damn well please. Would Mr. Henry police my charitable financial giving with the same zeal that he wishes living organ donations to be regulated?
Finally, I wish Mr. Henry best of luck with his forthcoming third kidney transplant. He indicated it will most likely be a paired or swap donation, another innovative solution to deadly kidney donor shortages. I only hope that the stranger whose kidney he receives is treated fairly and not subjected to name-calling in public forums.
Tom Simon is an FBI Special Agent in Chicago and a living kidney donor. His experiences as a living donor are recounted at www.kidneychronicles.blogspot.com. He can be reached at simonhere at mail dot com.
Saturday, July 28, 2007
Monday, July 16, 2007
Voice of the People
The Chicago Tribune printed a truncated version of my letter to the editor (see below). You can read their short version at:
http://newsblogs.chicagotribune.com/news_opinion_letters/2007/07/using-the-inter.html
Also, Brenda found an interesting article at:
http://www.ericksontribune.com/Home/TopStories/tabid/63/newsid404/5317/The-hidden-costs-behind-the-Gift-of-Life/Default.aspx
http://newsblogs.chicagotribune.com/news_opinion_letters/2007/07/using-the-inter.html
Also, Brenda found an interesting article at:
http://www.ericksontribune.com/Home/TopStories/tabid/63/newsid404/5317/The-hidden-costs-behind-the-Gift-of-Life/Default.aspx
Monday, July 9, 2007
Auditioning for a Kidney
The 7/9/2007 the Chicago Tribune printed an Op-Ed piece by Dr. Timothy Murphy, a professor at a local university where he beat up on Matching Donors. I submitted an Op-Ed piece in response to his article, but I have no idea if it will be published or not.
Here they both are, starting with Dr. Murphy's piece:
http://www.chicagotribune.com/news/opinion/chi-oped0709organsjul09,0,2650413.story?coll=chi-newsopinioncommentary-hed
Commentary
Auditioning for a kidney
Transplant policy should be revised so organs go to those most in need, not those with the best appeal for help
By Timothy F. Murphy, professor of philosophy in the biomedical sciences at the University of Illinois College of Medicine at Chicago
July 9, 2007
Dutch television delivered a reality TV show like no other. Producers followed a dying woman as she chose which of three competitors would get one of her kidneys for transplant. The advance details were vague, if only because it was all a hoax: Nobody was dying, and everyone involved was an actor. By way of defense, the producers said they wanted to draw attention to organ shortages.
Finding organs for donation still is an uphill struggle in most countries. In the United States, people do not donate organs and tissues after death in numbers equal to the need. Surprisingly, living organ donors are not always so scarce. For example, since 2000, the number of living people who have given up a kidney for a family member or friend has exceeded the number of people who have been willing to donate kidneys after death.
This inclination to donate to a real, live person--instead of an unknown person on a waiting list somewhere--helps sustain an Internet site that matches living donors with people waiting for organs and tissues. At matchingdonors. com, people waiting for organs and tissues say a bit about themselves and what a transplant would mean to them. In fact, complete strangers do step forward to donate to people whose stories they find compelling. After these donors are screened, surgeons move organs from one body to another, relationships are forged and lives are saved.
Any transplant patient who receives an organ because a living stranger comes forward via the Internet wins the equivalent of a transplantation lottery. But people using the Internet to solicit donors represent only a tiny fraction of the nearly 100,000 people waiting for organs and tissues in this country. This kind of Internet publicity creates an express lane for some patients, to the disadvantage of others. Most people waiting for transplants are invisible to the public as they quietly wait for donations from the dead.
United States transplant policy must move to acknowledge the role the Internet has come to play in direct organ donation. Good-hearted people are using the Internet to search out people who need organs, but this approach does an end run around policies crafted to balance need and availability. To resolve this problem, the government could move to put people in need of a transplant on the Web, at least those willing to go public that way with a picture, a story, and some words of solicitation.
This way, strangers could search the entire catalog of people needing organs, with no one excluded. Yet this approach would ultimately pit transplant patients against one another, with advantages falling to the sympathetic and manipulative. Dubious motives--racism, sexism, ageism--could distort donation decisions as well.
In the name of protecting access for all, another option might be to bar the practice of stranger donation unless the donor surrenders the right to direct where the organs go. Some medical centers already accept stranger donations and treat organs obtained this way as donations from the deceased.
For example, a kidney donated by a stranger goes to the appropriate person at the top of the regional waiting list. This way, nobody jumps the line, and the accidents of fate--one's disease, one's skin color, one's age--don't stand in the way of hope for the organ one needs to stay alive. This option seems reasonable to me, but there may be other options out there that protect access and equity when it comes to sharing all-too-scarce organs. Let's get a discussion under way.
The Dutch public was cool to a television program that treated organ transplantation as reality-show fodder.
In the United States, we should learn from that lesson and reject the idea that one's media appeal ought to decide who gets a lifesaving organ and who does not.
Copyright © 2007, Chicago Tribune
----------------------------------------------
Here is my response:
Internet Kidney Matches: A Donor's Perspective
by Tom Simon
On April 19, I donated a kidney to a woman I met via the website matchingdonors.com. As such, I would like to add my perspective to the thoughts and ideas presented by Dr. Timothy Murphy in his July 9 commentary "Auditioning for a Kidney."
In his piece, Dr. Murphy makes the point that sites such as Matching Donors that allow potential organ recipients to present their cases to the public in hopes of finding a living donor are inherently unfair because they tend to reward the people with the best self-marketing skills rather than with the greatest medical need. He also makes the point that irrational biases such as race, gender, and age may unfairly factor into the donor's decision as to who will be rewarded with the life-saving gift of a vital organ.
When I made the choice to donate a kidney to a stranger, I began the process as a non-directed donor -- meaning I was prepared to let Northwestern Memorial Hospital choose my recipient for me. I immediately began to have misgivings about this approach. What if my kidney wound up inside a registered sex offender or a violent ex-convict? My personal biases were less demographically focused and more lifestyle-based. I was less interested in saving the sickest person I could find, and more interested in saving the life of someone who could make a difference in the world once their health was restored to normal.
I spent some time searching the Matching Donors site until I found the posting of a Chicago woman named Brenda for whom I felt a great deal of empathy. She was young, aspired to have kids, and worked as a domestic violence court victim advocate for the Cook County States Attorneys office. She was also experiencing severe kidney failure combined with complications arising from dialysis. My wife and I discussed the morality of "playing God" and deciding who lives and dies. Finally, I decided to donate my kidney to Brenda for the following reason: if I had let the hospital pick my recipient, I would've hoped that my recipient's personal story be just like Brenda's story. Given that reality, the final decision was easy.
The internet empowers the donor to make his own choice as to whom benefits from the gift of an organ donation. I also feel that as more people take advantage of the internet as a means to match donors and recipients, you will see less donors "chickening out" at the last minute. Being able to put a face and name with your intended recipient creates empathy and accountability – two major deterrents to backing out of this life-saving act moments before surgery.
I see nothing wrong with letting my emotions, preferences, and biases shape my decision regarding who gets my kidney. No one is troubled if I choose to give my other assets (i.e. cash) to people and causes I support. Why do people such as Dr. Murphy short-circuit when I decide to give my kidney to a person I support? Would he police my charitable financial giving with the same zeal that he wishes living organ donations to be regulated?
Dr. Murphy wisely suggested launching a website where all 100,000 needy potential organ recipients in America could put their stories on the web for the public to peruse. I suspect that matchingdonors.com would welcome the opportunity to serve this purpose. The good people at that website (with whom I have no affiliation) recently inked a deal to put 100% of the transplant waiting list of the Commonwealth of the Bahamas on their site. Dr. Murphy lost me, however, when he suggested the alternative of banning the practice of organ donations from strangers that permit the donor to pick a recipient.
The number of individuals currently waiting for a kidney transplant in the United States is nearly 100,000. This year, only about 100 of these individuals will receive kidneys from living strangers -- about half from anonymous living donors and half from people like me who sought out their donors on the internet. The Matching Donors website is responsible for a total of only 47 organ transplants -- hardly a cause for much ethical hand-wringing when lives are being saved by "biased" donors such as me.
I would respectfully recommend that thinkers like Dr. Murphy put some energy into increasing the number of living donors in America rather than scolding and disempowering those of us who stepped up to help.
Here they both are, starting with Dr. Murphy's piece:
http://www.chicagotribune.com/news/opinion/chi-oped0709organsjul09,0,2650413.story?coll=chi-newsopinioncommentary-hed
Commentary
Auditioning for a kidney
Transplant policy should be revised so organs go to those most in need, not those with the best appeal for help
By Timothy F. Murphy, professor of philosophy in the biomedical sciences at the University of Illinois College of Medicine at Chicago
July 9, 2007
Dutch television delivered a reality TV show like no other. Producers followed a dying woman as she chose which of three competitors would get one of her kidneys for transplant. The advance details were vague, if only because it was all a hoax: Nobody was dying, and everyone involved was an actor. By way of defense, the producers said they wanted to draw attention to organ shortages.
Finding organs for donation still is an uphill struggle in most countries. In the United States, people do not donate organs and tissues after death in numbers equal to the need. Surprisingly, living organ donors are not always so scarce. For example, since 2000, the number of living people who have given up a kidney for a family member or friend has exceeded the number of people who have been willing to donate kidneys after death.
This inclination to donate to a real, live person--instead of an unknown person on a waiting list somewhere--helps sustain an Internet site that matches living donors with people waiting for organs and tissues. At matchingdonors. com, people waiting for organs and tissues say a bit about themselves and what a transplant would mean to them. In fact, complete strangers do step forward to donate to people whose stories they find compelling. After these donors are screened, surgeons move organs from one body to another, relationships are forged and lives are saved.
Any transplant patient who receives an organ because a living stranger comes forward via the Internet wins the equivalent of a transplantation lottery. But people using the Internet to solicit donors represent only a tiny fraction of the nearly 100,000 people waiting for organs and tissues in this country. This kind of Internet publicity creates an express lane for some patients, to the disadvantage of others. Most people waiting for transplants are invisible to the public as they quietly wait for donations from the dead.
United States transplant policy must move to acknowledge the role the Internet has come to play in direct organ donation. Good-hearted people are using the Internet to search out people who need organs, but this approach does an end run around policies crafted to balance need and availability. To resolve this problem, the government could move to put people in need of a transplant on the Web, at least those willing to go public that way with a picture, a story, and some words of solicitation.
This way, strangers could search the entire catalog of people needing organs, with no one excluded. Yet this approach would ultimately pit transplant patients against one another, with advantages falling to the sympathetic and manipulative. Dubious motives--racism, sexism, ageism--could distort donation decisions as well.
In the name of protecting access for all, another option might be to bar the practice of stranger donation unless the donor surrenders the right to direct where the organs go. Some medical centers already accept stranger donations and treat organs obtained this way as donations from the deceased.
For example, a kidney donated by a stranger goes to the appropriate person at the top of the regional waiting list. This way, nobody jumps the line, and the accidents of fate--one's disease, one's skin color, one's age--don't stand in the way of hope for the organ one needs to stay alive. This option seems reasonable to me, but there may be other options out there that protect access and equity when it comes to sharing all-too-scarce organs. Let's get a discussion under way.
The Dutch public was cool to a television program that treated organ transplantation as reality-show fodder.
In the United States, we should learn from that lesson and reject the idea that one's media appeal ought to decide who gets a lifesaving organ and who does not.
Copyright © 2007, Chicago Tribune
----------------------------------------------
Here is my response:
Internet Kidney Matches: A Donor's Perspective
by Tom Simon
On April 19, I donated a kidney to a woman I met via the website matchingdonors.com. As such, I would like to add my perspective to the thoughts and ideas presented by Dr. Timothy Murphy in his July 9 commentary "Auditioning for a Kidney."
In his piece, Dr. Murphy makes the point that sites such as Matching Donors that allow potential organ recipients to present their cases to the public in hopes of finding a living donor are inherently unfair because they tend to reward the people with the best self-marketing skills rather than with the greatest medical need. He also makes the point that irrational biases such as race, gender, and age may unfairly factor into the donor's decision as to who will be rewarded with the life-saving gift of a vital organ.
When I made the choice to donate a kidney to a stranger, I began the process as a non-directed donor -- meaning I was prepared to let Northwestern Memorial Hospital choose my recipient for me. I immediately began to have misgivings about this approach. What if my kidney wound up inside a registered sex offender or a violent ex-convict? My personal biases were less demographically focused and more lifestyle-based. I was less interested in saving the sickest person I could find, and more interested in saving the life of someone who could make a difference in the world once their health was restored to normal.
I spent some time searching the Matching Donors site until I found the posting of a Chicago woman named Brenda for whom I felt a great deal of empathy. She was young, aspired to have kids, and worked as a domestic violence court victim advocate for the Cook County States Attorneys office. She was also experiencing severe kidney failure combined with complications arising from dialysis. My wife and I discussed the morality of "playing God" and deciding who lives and dies. Finally, I decided to donate my kidney to Brenda for the following reason: if I had let the hospital pick my recipient, I would've hoped that my recipient's personal story be just like Brenda's story. Given that reality, the final decision was easy.
The internet empowers the donor to make his own choice as to whom benefits from the gift of an organ donation. I also feel that as more people take advantage of the internet as a means to match donors and recipients, you will see less donors "chickening out" at the last minute. Being able to put a face and name with your intended recipient creates empathy and accountability – two major deterrents to backing out of this life-saving act moments before surgery.
I see nothing wrong with letting my emotions, preferences, and biases shape my decision regarding who gets my kidney. No one is troubled if I choose to give my other assets (i.e. cash) to people and causes I support. Why do people such as Dr. Murphy short-circuit when I decide to give my kidney to a person I support? Would he police my charitable financial giving with the same zeal that he wishes living organ donations to be regulated?
Dr. Murphy wisely suggested launching a website where all 100,000 needy potential organ recipients in America could put their stories on the web for the public to peruse. I suspect that matchingdonors.com would welcome the opportunity to serve this purpose. The good people at that website (with whom I have no affiliation) recently inked a deal to put 100% of the transplant waiting list of the Commonwealth of the Bahamas on their site. Dr. Murphy lost me, however, when he suggested the alternative of banning the practice of organ donations from strangers that permit the donor to pick a recipient.
The number of individuals currently waiting for a kidney transplant in the United States is nearly 100,000. This year, only about 100 of these individuals will receive kidneys from living strangers -- about half from anonymous living donors and half from people like me who sought out their donors on the internet. The Matching Donors website is responsible for a total of only 47 organ transplants -- hardly a cause for much ethical hand-wringing when lives are being saved by "biased" donors such as me.
I would respectfully recommend that thinkers like Dr. Murphy put some energy into increasing the number of living donors in America rather than scolding and disempowering those of us who stepped up to help.
Subscribe to:
Posts (Atom)
