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RS 177 - Dylan Matthews on "The science and ethics of kidney donation"

Release date: February 5th, 2017

Dylan Matthews

If you're a healthy adult, should you donate one of your kidneys to a stranger? This episode features journalist Dylan Matthews, who donated his kidney last year. He and Julia discuss the clever design of "donor chains," how we should evaluate the science about whether kidney donation is safe, and whether we have an ethical obligation to donate.

Dylan's Pick #1: Reasons and Persons by Derek Parfit

Dylan's Pick #2: "Waitlist Zero" Website

Dylan's Pick #3: "Kidney donation is a reasonable choice for effective altruists and more should consider it" by Tom Ash

Edited by Brent Silk

Music by Miracles of Modern Science


Full Transcripts 

Reader Comments (14)

One has to be very brave and humane to gave a kidney to a stranger.
Thank you for the interesting material for reflection.
Dylan Matthews great man!
There's an interesting New Yorker profile of Zell Kravinsky, who also donated a kidney to a stranger. But unlike Matthews, Kravinsky thinks that you *are* morally required to donate a kidney.

Kravinsky's argument goes like this. (1) The chance of dying from donating a kidney is only 1 in 4000. So (2) if you do not donate a kidney, then you're valuing yourself more than 4000 times as much as you value the person whose life you could save by donating. But (3) it's wrong to value yourself more than 4000 times as much as someone else. So (4) it's wrong for you not to donate a kidney. (In other words, you are morally required to donate a kidney.)

I take it that the step from (1) to (2) is supposed to be justified by the fact that, given (1), the only way to make the expected utility of not donating a kidney come out as greater than the expected utility of donating a kidney is to value yourself more than 4000 times as much as the person whose life you could save.
February 7, 2017 | Unregistered Commentercat1
Haven't you seen the Curb Your Enthusiasm Season 5 finale, where Larry becomes a Christian and donates his kidney?
But seriously, it's a real shame when kidney donors die, especially when the kidney is rejected by the recipient, or when donating to a parent like this guy:
"Sons bury their fathers. In this case, I get to bury Jamie. That's not that way it's supposed to be," Donaldson said.
February 8, 2017 | Unregistered CommenterMax
cat1, what if the chance of dying were 1 in 6? Is it wrong to value yourself six times as much as someone else? If so, how about just donating all your organs to save six people: kidneys, liver, heart, lungs. You'll die, but you'll save six people! Or donate your child's organs to save six random children, how about that? Or how about kidney theft to save a life?
Crazy fundamentalist consequentialism.
February 8, 2017 | Unregistered CommenterMax
It's hard enough to convince people to get a colonoscopy cancer screening for their own benefit, and you're talking about donating kidneys to strangers for brownie points.
February 8, 2017 | Unregistered CommenterMax
Hi Max,

One of your objections seems to be that Karvinsky's argument overgeneralizes to show that you're morally required to give up *all* of your organs (and your life) to save even more people. But I don't think that his argument overgeneralizes in this way. Maybe it's morally permissible to value yourself a bit more than you value someone else. All his argument says is that valuing yourself more than 4000 times as much as you value someone else is wrong. That leaves open the possibility that valuing yourself merely 6 or 10 times as much as you value someone else is morally permissible. (I'm not really sure where we should draw the line, but it seems plausible to me that there is some point at which it becomes wrong to value yourself so much more than you value someone else.)

It's also worth noting that Karvinsky's argument doesn't assume that consequentialism is true. If you assume that consequentialism is true, then it's easy to argue that you're morally required to donate a kidney: doing so would produce the best consequences. But that's not the argument that Karvinsky makes. So even non-consequentialists need to grapple with it.

By the way, here's a (paywalled) link to the New Yorker profile of Kravinsky:
February 8, 2017 | Unregistered Commentercat1
Hello everybody.
Esan Hospital is looking for kidney donor in anywhere in world, so if you want to sell your kidney and be rich or to save someone life please kindly contact us for more details as we are ready to offer you big amount of $600,000.00 without any stress, So this is your opportunity for you to sell your kidney for money:

Best regard
Dr Pramod Kumar
Please call +918867413844
February 17, 2017 | Unregistered CommenterPramod
More on the algorithms that discover donor chains:
March 26, 2017 | Unregistered CommenterJoshM
I have received Dylan's kidney and the quality of my life is greatly improved and at one year, I no longer have to go to the transplant clinic and only have to see my personal nephrologist every three months. I am grateful beyond belief that Dylan (who I did not know previously) was kind enough to help me extend my life. Did you know that you can live a completely normal life with only one kidney?
If I had an extra kidney to give, I certainly would. And my the way, my loving daughter gave one of her kidneys to shorten my wait from 5-7 years to 15months.
October 3, 2017 | Unregistered CommenterNeil Rothe

this is to inform the general public that healthy Kidney donors are needed from all blood groups by Manipal Hospita, each donor gets 1 crore 20 lakhs. Advance payment will be paid first to the donor before the operation will commence after which the balance will be paid after the completion of the operation. hurry now and contact us via email or WhatsApp +918867413844

Best regard
Dr Pramod
WhatsApp +918867413844
November 29, 2017 | Unregistered CommenterPramod
The kidney shortage problem has an obvious answer. Simply allow people to SELL their extra kidney. Also, people who voluntarily give up a kidney, or other organ, should get priority for receiving a transplant any other organ they might need later in life.
December 5, 2017 | Unregistered CommenterJameson
Welcome to SPECIALIST NEPHROLOGIST TRANSPLANT HOSPITAL that buy kidney. Do you wish to sell your kidney in exchange of money for the Sum $220,000.00 ,advance payment $110,000.00 If Anyone is interested in selling his/her kidney should contact Doctor James Francis today to get a reliable and good transaction for good money.please contact via ( )Phone : +233260941872 Please Note: Internet there are a lot of people with different motive, So Please be sincere and truthful we are not kid, this is about saving lives of others.Fraudulent is not accepted please. Best Regards. Dr.James Francis
December 6, 2017 | Unregistered Commenterfjames
I received my one year old kidney transplant from Dylan. I had never met Dylan and I can't begin to express my appreciation for the kindness of this altruistic stranger who had perhaps saved my life. I'm one year out and doing fabulously with his kidney. Here is to you Dylan! I have misplaced your email address and would love to contact you so that we can get together for lunch as we had discussed in an earlier email.

I am also grateful to my daughter who gave one of her kidneys so I wouldn't have to wait a full seven years (this time frame is estimated)
and, as it turned out, one day after my daughter and I were put on the national wait list, Dylan's kidney became available.

Hope to here from Dylan soon!
December 10, 2017 | Unregistered CommenterNeil

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