Re: kidney patient sues hospital over kidney transplant

March 24, 2005

Good morning Pierre,

I went to the web site, and I have to say that I agree too. Of course I

feel for anyone who is waiting for a kidney, but you are right about not

following the proper channels everyone else has to.

In a message dated 3/24/2005 3:46:57 A.M. Pacific Standard Time,

pgl-groups@... writes:

I think the hospital is doing the right thing. This potential donor was

obtained through www.matchingdonors.com , and it's a similar case to the one

in the US a few months ago. At the time, for that one, it was claimed there

was no compensation, but this turned out to be false.

You can go to www.matchingdonors.com and see the guy's listing:

http://www.matchingdonors.com/life/Donor/search.cfm?page=position-description &

JobID=%24%22%2DHK2%40%20%20%0A & CFID=3115743 & CFTOKEN=92182261

If the link doesn't work, just go to the site. www.matchingdonors.com ,

choose Canada in the search box (leave the rest empty), and Baruch Tegegne

is the first person who comes up. That's the guy needing the kidney. He's

only been on the waiting list for a couple of years. I don't see why he

should get a kidney ahead of anyone else. I've been waiting 2 and half

years, and many people I know have been waiting much longer. If someone in

India desperately wants to give a kidney to a stranger in Canada out of the

goodness of his heart, then let him give it to the next person on the

waiting list who matches (this is called altruistic anonymous donation). Or

better yet, why doesn't he donate his kidney to one of the thousands of

people waiting for a kidney in India? You can see how any transplant centre

would view this as suspicious. In Canada, to be a live kidney donor, you

have to either be a relative or you have to be able to demonstrate a

longstanding relationship as a friend with the intended recipient. This is

to prevent secret, under-the-table buying and selling of organs, and I

personally think it's the right thing. In addition to all the above, this

man wants the Canadian taxpayer to pay for installing his illegally-obtained

kidney.

I encourage you to go and read that matchingdonors.com listing. I could come

up with a pretty compelling ad too, if I wanted. Anyone on dialysis could.

Pierre

March 27, 2005

Thanks Pierre,

I'm all quite new to all the ethical issues regarding live organ

donations. I appreciate all the insight that you have given me

regarding this. Instictively, I felt the hospital was in the right,

but got kinda confused of course because my husband offered to

donate his kidney to me.

Sophia

> I think the hospital is doing the right thing. This potential

donor was

> obtained through www.matchingdonors.com , and it's a similar case

to the one

> in the US a few months ago. At the time, for that one, it was

claimed there

> was no compensation, but this turned out to be false.

>

> You can go to www.matchingdonors.com and see the guy's listing:

>

> http://www.matchingdonors.com/life/Donor/search.cfm?page=position-

description & JobID=%24%22%2DHK2%40%20%20%

0A & CFID=3115743 & CFTOKEN=92182261

>

> If the link doesn't work, just go to the site.

www.matchingdonors.com ,

> choose Canada in the search box (leave the rest empty), and Baruch

Tegegne

> is the first person who comes up. That's the guy needing the

kidney. He's

> only been on the waiting list for a couple of years. I don't see

why he

> should get a kidney ahead of anyone else. I've been waiting 2 and

half

> years, and many people I know have been waiting much longer. If

someone in

> India desperately wants to give a kidney to a stranger in Canada

out of the

> goodness of his heart, then let him give it to the next person on

the

> waiting list who matches (this is called altruistic anonymous

donation). Or

> better yet, why doesn't he donate his kidney to one of the

thousands of

> people waiting for a kidney in India? You can see how any

transplant centre

> would view this as suspicious. In Canada, to be a live kidney

donor, you

> have to either be a relative or you have to be able to demonstrate

a

> longstanding relationship as a friend with the intended recipient.

This is

> to prevent secret, under-the-table buying and selling of organs,

and I

> personally think it's the right thing. In addition to all the

above, this

> man wants the Canadian taxpayer to pay for installing his

illegally-obtained

> kidney.

>

> I encourage you to go and read that matchingdonors.com listing. I

could come

> up with a pretty compelling ad too, if I wanted. Anyone on

dialysis could.

>

> Pierre

>

> kidney patient sues hospital over kidney transplant

>

> >

> > Hi everyone,

> >

> > I've been pretty busy these days, but I noticed this news article

> > yesterday or the day before, regarding a kidney patient who

found a

> > donor in India, but the hospital refused treatment since it

couldn't

> > determine that the donor was not selling his kidney.

> >

> > Last night on the news on TV, they apparently interviewed the guy

> > from India who wanted to donate. And apparently, he only wants

lost

> > wages and travel expenses when donating his kidney.

> >

> > I find that it is kind of interesting that the kidney patient is

> > suing on the basis of a " right to life and medical assistance

under

> > the Canada Health Act " .

> >

> > It also got me wondering: assuming this is truly a donation,

save

> > for reimbursement for lost wages and travel expenses, is it

really

> > all that different from me asking a friend (or my husband or one

of

> > my relatives) to donate a kidney for me?

> >

> > What do you think?

> >

> > Sophia

> >

> > http://www.cbc.ca/story/science/national/2005/03/22/kidney-

> > lawsuit050322.html

> >

> > To edit your settings for the group, go to our Yahoo Group

> > home page:

> > http://groups.yahoo.com/group/iga-nephropathy/

> >

> > To unsubcribe via email,

> > iga-nephropathy-unsubscribe

> > Visit our companion website at www.igan.ca. The site is entirely

supported

> by donations. If you would like to help, go to:

> > http://www.igan.ca/id62.htm

> >

> > Thank you

> >

March 27, 2005

Thanks Pierre,

I'm all quite new to all the ethical issues regarding live organ

donations. I appreciate all the insight that you have given me

regarding this. Instictively, I felt the hospital was in the right,

but got kinda confused of course because my husband offered to

donate his kidney to me.

Sophia

> I think the hospital is doing the right thing. This potential

donor was

> obtained through www.matchingdonors.com , and it's a similar case

to the one

> in the US a few months ago. At the time, for that one, it was

claimed there

> was no compensation, but this turned out to be false.

>

> You can go to www.matchingdonors.com and see the guy's listing:

>

> http://www.matchingdonors.com/life/Donor/search.cfm?page=position-

description & JobID=%24%22%2DHK2%40%20%20%

0A & CFID=3115743 & CFTOKEN=92182261

>

> If the link doesn't work, just go to the site.

www.matchingdonors.com ,

> choose Canada in the search box (leave the rest empty), and Baruch

Tegegne

> is the first person who comes up. That's the guy needing the

kidney. He's

> only been on the waiting list for a couple of years. I don't see

why he

> should get a kidney ahead of anyone else. I've been waiting 2 and

half

> years, and many people I know have been waiting much longer. If

someone in

> India desperately wants to give a kidney to a stranger in Canada

out of the

> goodness of his heart, then let him give it to the next person on

the

> waiting list who matches (this is called altruistic anonymous

donation). Or

> better yet, why doesn't he donate his kidney to one of the

thousands of

> people waiting for a kidney in India? You can see how any

transplant centre

> would view this as suspicious. In Canada, to be a live kidney

donor, you

> have to either be a relative or you have to be able to demonstrate

a

> longstanding relationship as a friend with the intended recipient.

This is

> to prevent secret, under-the-table buying and selling of organs,

and I

> personally think it's the right thing. In addition to all the

above, this

> man wants the Canadian taxpayer to pay for installing his

illegally-obtained

> kidney.

>

> I encourage you to go and read that matchingdonors.com listing. I

could come

> up with a pretty compelling ad too, if I wanted. Anyone on

dialysis could.

>

> Pierre

>

> kidney patient sues hospital over kidney transplant

>

> >

> > Hi everyone,

> >

> > I've been pretty busy these days, but I noticed this news article

> > yesterday or the day before, regarding a kidney patient who

found a

> > donor in India, but the hospital refused treatment since it

couldn't

> > determine that the donor was not selling his kidney.

> >

> > Last night on the news on TV, they apparently interviewed the guy

> > from India who wanted to donate. And apparently, he only wants

lost

> > wages and travel expenses when donating his kidney.

> >

> > I find that it is kind of interesting that the kidney patient is

> > suing on the basis of a " right to life and medical assistance

under

> > the Canada Health Act " .

> >

> > It also got me wondering: assuming this is truly a donation,

save

> > for reimbursement for lost wages and travel expenses, is it

really

> > all that different from me asking a friend (or my husband or one

of

> > my relatives) to donate a kidney for me?

> >

> > What do you think?

> >

> > Sophia

> >

> > http://www.cbc.ca/story/science/national/2005/03/22/kidney-

> > lawsuit050322.html

> >

> > To edit your settings for the group, go to our Yahoo Group

> > home page:

> > http://groups.yahoo.com/group/iga-nephropathy/

> >

> > To unsubcribe via email,

> > iga-nephropathy-unsubscribe

> > Visit our companion website at www.igan.ca. The site is entirely

supported

> by donations. If you would like to help, go to:

> > http://www.igan.ca/id62.htm

> >

> > Thank you

> >

March 27, 2005

Thanks Pierre,

I'm all quite new to all the ethical issues regarding live organ

donations. I appreciate all the insight that you have given me

regarding this. Instictively, I felt the hospital was in the right,

but got kinda confused of course because my husband offered to

donate his kidney to me.

Sophia

> I think the hospital is doing the right thing. This potential

donor was

> obtained through www.matchingdonors.com , and it's a similar case

to the one

> in the US a few months ago. At the time, for that one, it was

claimed there

> was no compensation, but this turned out to be false.

>

> You can go to www.matchingdonors.com and see the guy's listing:

>

> http://www.matchingdonors.com/life/Donor/search.cfm?page=position-

description & JobID=%24%22%2DHK2%40%20%20%

0A & CFID=3115743 & CFTOKEN=92182261

>

> If the link doesn't work, just go to the site.

www.matchingdonors.com ,

> choose Canada in the search box (leave the rest empty), and Baruch

Tegegne

> is the first person who comes up. That's the guy needing the

kidney. He's

> only been on the waiting list for a couple of years. I don't see

why he

> should get a kidney ahead of anyone else. I've been waiting 2 and

half

> years, and many people I know have been waiting much longer. If

someone in

> India desperately wants to give a kidney to a stranger in Canada

out of the

> goodness of his heart, then let him give it to the next person on

the

> waiting list who matches (this is called altruistic anonymous

donation). Or

> better yet, why doesn't he donate his kidney to one of the

thousands of

> people waiting for a kidney in India? You can see how any

transplant centre

> would view this as suspicious. In Canada, to be a live kidney

donor, you

> have to either be a relative or you have to be able to demonstrate

a

> longstanding relationship as a friend with the intended recipient.

This is

> to prevent secret, under-the-table buying and selling of organs,

and I

> personally think it's the right thing. In addition to all the

above, this

> man wants the Canadian taxpayer to pay for installing his

illegally-obtained

> kidney.

>

> I encourage you to go and read that matchingdonors.com listing. I

could come

> up with a pretty compelling ad too, if I wanted. Anyone on

dialysis could.

>

> Pierre

>

> kidney patient sues hospital over kidney transplant

>

> >

> > Hi everyone,

> >

> > I've been pretty busy these days, but I noticed this news article

> > yesterday or the day before, regarding a kidney patient who

found a

> > donor in India, but the hospital refused treatment since it

couldn't

> > determine that the donor was not selling his kidney.

> >

> > Last night on the news on TV, they apparently interviewed the guy

> > from India who wanted to donate. And apparently, he only wants

lost

> > wages and travel expenses when donating his kidney.

> >

> > I find that it is kind of interesting that the kidney patient is

> > suing on the basis of a " right to life and medical assistance

under

> > the Canada Health Act " .

> >

> > It also got me wondering: assuming this is truly a donation,

save

> > for reimbursement for lost wages and travel expenses, is it

really

> > all that different from me asking a friend (or my husband or one

of

> > my relatives) to donate a kidney for me?

> >

> > What do you think?

> >

> > Sophia

> >

> > http://www.cbc.ca/story/science/national/2005/03/22/kidney-

> > lawsuit050322.html

> >

> > To edit your settings for the group, go to our Yahoo Group

> > home page:

> > http://groups.yahoo.com/group/iga-nephropathy/

> >

> > To unsubcribe via email,

> > iga-nephropathy-unsubscribe

> > Visit our companion website at www.igan.ca. The site is entirely

supported

> by donations. If you would like to help, go to:

> > http://www.igan.ca/id62.htm

> >

> > Thank you

> >

March 27, 2005

Wow, this one gets complicated in a hurry.....

However, my first question is how does an organization prove a negative? In

other words, for living unrelated donors here in the USA, the psychological

interviews and queries are designed to determine if compensation is being

paid directly for the kidney (as opposed to reimbursement of expenses, lost

wages, and such). So I don't get the hospital refusing the procedure when

both parties asserted no cash, other than expenses, was changing hands.

Covering expenses for donation, such as lost wages, is a very common

practice, and of course the medical expenses are born by the Tx recipient's

insurance (be that private or Medicare or both).

If one can't find a decent match amongst family and friends, the option is

offered of having someone who desires to donate a kindey to the list, under

the theory that the " next, " cadaver kidney would then come to the person who

arranged the donation. In this case, though, it is hardly an even

trade.....one person gets a live donation and the other gets a cadaver

kidney, so I don't advocate this. Domino donation, in which TWO or more

unrelated donor:recipient pairs are arranged and transplanted at the same

time, are becoming more common.

I am in the position above...no compatible living donors are available. I

had a girlfriend who promised a kidney, but then we broke off our

relationship....and thus the offer was withdrawn. Two others offered as

well, but both are over 50 and are thus considered poor risks and are

ineligible.

The practice of selling kidneys is known to occur, and as macabre as it is,

if I had any confidence that such a thing could be done successfully, in

decent surroundings, etc. (and if I had sufficient coinage, which I don't)

despite the ethics of it all I would consider it. Probably wouldn't do it,

but would consider it.

The bottom line, though, is in the US at least we are facing literally a

dialysis crisis, for several reasons:

- Its largely paid for by the government, at more or less the same rates it

has been for many years

- Far more people (about 3x now) are expected to be dialyzing as the

boomers age and as the frequency of diabetes increases

- Only about 30 to 40% of families who face the misfortunate question of

donation agree to do so (in fact, I had a brother who died of a head injury

in 1975, and my Dad said no to him being a donor, even though the rest of

us, Mom included, wanted this done....a wasted death seemed senseless. I

begged my Dad to change his mind, but no dice. The irony of my current

situation is not lost upon me) And, as the number of folks on the list

rise, the wait time does, also. In addition, and this is a good thing in

one way and not in another, the supply of cadaver donors is decreasing in

proportion to the population (I attribute much of this to the almost

fanatical attention paid to safety...even kids on bicycles are wearing

helmets now). Good, obviously, but...

- due to the huge costs associated with dialysis I expect we will go back

to relative rationing of this type of care. In fact we already are....most

poeple in the US on in-center 3x/week hemo are underdialyzed, and believe it

not according to Medicare, some folks skip sessions, too. Judging by

Pierre's descriptions, megatons of STUFF get used during a dialysis session,

and I am sure this is true of PD as well.

- For all of the above reasons I think donation should be presumptive

rather than relying on the family. Even if I have an organ donor card in my

wallet....it is what my family says that counts....virtually no facility in

the US will perform organ harvests, no matter what documentation the person

has on him, if donation is contrary to the familial wishes as expressed at

the time. This makes the organ donation card situation a monumental farce,

unfortunately.

- As the lifetime of a cadaver kidney is on average more or less 10 years,

as I am 43, I will likely need more than one transplant. The era of 3 and 4

transplants per recipient are over in the US, as wait times on the list will

approach ten years and more because a) reciepients will be healthier and

live longer and more people will be on the list.

- Someone on this list, some time ago, suggested using criminals - those

subject to lethal injection - as donors. Completely aside from my thoughts

re the death penalty (barbaric, unnecessary, and more expensive than

lifetime incarceration) the drugs used destroy the organs (potassium

chloride, a curare deriative, and sodium thiopental - all in huge amounts).

- I have suggested to my own neph that I be allowed to do a different type

of swap....namely half a liver for a kidney. You should have seen the look

on her face....before she said this would be far too dangerous and she

wouldn't support the concept.

Having listed a lot of problems, here are a few solutions:

1. Make donation presumptive such that the individual must opt out of

donation and carry a card to that affect, and leave the family out of it -

not likely to happen in the US

2. Allow small (or large for that matter) payments to living kidney

donors - also not likely here in the US

3. Spend some real money on public education, etc. re organ donation. We

spend BILLIONS per year on dialysis...while a Tx and the meds after are very

expensive, studies show there is a positive NPV after about 3 years. I

don't know what we spend on donor education, but it isn't much and much of

that is doubtless private money.

4. Tighten the criteria for those who are eligible to become reciepients

(i.e. having comorbid conditions, etc.) - not likely here in the US,

either, we have an " anti-elitist " attitude in this country...and indeed the

trend is the other way

5. Loosen the criteria for donation, both living and cadaver - to some

degree this is already being done; for over 50 cadavers the TX team will

consider transplanting both kidneys into one recipient, as is done with

infant/young children cadaver donations. They are even allowing limited

HIV+ to HIV+ donor recipient combinations. Aside from ethical

considerations, I think it is a shame that this woman in Florida is being

allowed to starve to death....with a completely usable set of kidneys,

liver, etc. Typically we have restricted donors to living volunteers or

those who have died traumatically....its not clear that we extend this to

folks who die of stroke, heart attacks, etc. It takes HOURS for the kindeys

to become sufficiently ischemic as to be useless. Where medically possible,

organ donation should be the norm not the exception.

6. Loosen the criteria for organ swapping - ex my half liver for a kidney

idea. I intend to pursue this with great vigor.

7. Pursue methods for dialysis that more closely mimic genuine kidney

function - this is being pursued with vigor and largely consists of having

living kidney cells in the extracorporeal dialysis loop for hormonogenesis,

some kidney metabolic functions not related to waste removal, etc.

8. Pursue methods for dialysis that are more palatable to the client

population on a daily basis. The Aksys people seem to be doing this well...

I've written a huge post, but...these things are quite naturally on my mind.

Thoughts?

Bart

kidney patient sues hospital over kidney transplant

Hi everyone,

I've been pretty busy these days, but I noticed this news article

yesterday or the day before, regarding a kidney patient who found a

donor in India, but the hospital refused treatment since it couldn't

determine that the donor was not selling his kidney.

Last night on the news on TV, they apparently interviewed the guy

from India who wanted to donate. And apparently, he only wants lost

wages and travel expenses when donating his kidney.

I find that it is kind of interesting that the kidney patient is

suing on the basis of a " right to life and medical assistance under

the Canada Health Act " .

It also got me wondering: assuming this is truly a donation, save

for reimbursement for lost wages and travel expenses, is it really

all that different from me asking a friend (or my husband or one of

my relatives) to donate a kidney for me?

What do you think?

Sophia

http://www.cbc.ca/story/science/national/2005/03/22/kidney-

lawsuit050322.html

To edit your settings for the group, go to our Yahoo Group

home page:

http://groups.yahoo.com/group/iga-nephropathy/

To unsubcribe via email,

iga-nephropathy-unsubscribe

Visit our companion website at www.igan.ca. The site is entirely supported

by donations. If you would like to help, go to:

http://www.igan.ca/id62.htm

Thank you

March 27, 2005