INTRODUCTION Chronic kidney disease is a prevalent and dire condition that affects more than 20 million Americans (CDC 2015). In cases of end-stage renal failure, a patient must receive treatment to compensate for the complete failure of the kidneys. Currently, kidney transplantation is the preferred treatment for this condition. Compared to the alternative of long-term dialysis, transplantation offers a better quality of life, is more than twice as effective at improving the long-term prognosis of the patient, and is cheaper. However, there is a significant shortage of available kidneys in the United States. Of the approximately 110,000 people in the United States currently on the kidney transplant waiting list, only 15% ever receive the
…show more content…
Living donation of kidneys is allowed in the United States so long as the donor does not receive any form of payment. Participating in organ transplantation is widely accepted as an ethical practice for physicians, despite the fact that unnecessary surgical intervention might pose both immediate and long-term risks to a donor. The acceptance of the practice is largely due to the low-risk nature of this procedure. While there is a risk of long-term morbidity that must not be ignored, donors show almost no increase in long-term mortality (Hartman et al 2003, 871-873). Additionally, one is hard pressed to find accusations of unethical behavior when a patient accepts an organ from another person to improve their own quality of life (Kishore 2005, 363). There is a key difference, however, between physician participation in an altruistic donor system and one that might exploit a large portion of the community that they serve. If one accepts that kidney transplantation to be ethical while also acknowledging that paying donors would disproportionately encourage donation by the most vulnerable, then it is apparent that such a practice would be unethical on the part of the health professionals who serve to protect the beneficence of their patients and communities. Due to their social status and knowledge, physicians are uniquely effective advocates for their professional obligations, which include engagement in actions that helps combat socioeconomic conditions that influence care (Gruen and Pearson 2004, 95). Ensuring that vulnerable patients are not exploited by guiding major decisions about their health through financial motivation is certainly an example of this
Living donation of kidneys is allowed in the United States so long as the donor does not receive any form of payment. Participating in organ transplantation is widely accepted as an ethical practice for physicians, despite the fact that unnecessary surgical intervention might pose both immediate and long-term risks to a donor. The acceptance of the practice is largely due to the low-risk nature of this procedure. While there is a risk of long-term morbidity that must not be ignored, donors show almost no increase in long-term mortality (Hartman et al 2003, 871-873). Additionally, one is hard pressed to find accusations of unethical behavior when a patient accepts an organ from another person to improve their own quality of life (Kishore 2005, 363). There is a key difference, however, between physician participation in an altruistic donor system and one that might exploit a large portion of the community that they serve. If one accepts that kidney transplantation to be ethical while also acknowledging that paying donors would disproportionately encourage donation by the most vulnerable, then it is apparent that such a practice would be unethical on the part of the health professionals who serve to protect the beneficence of their patients and communities. Due to their social status and knowledge, physicians are uniquely effective advocates for their professional obligations, which include engagement in actions that helps combat socioeconomic conditions that influence care (Gruen and Pearson 2004, 95). Ensuring that vulnerable patients are not exploited by guiding major decisions about their health through financial motivation is certainly an example of this