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A gift that comes with a built-in responsibility

01 May 2015

Organ donation can offer comfort in the face of devastating loss, but it can also be an expression of pure altruism, says Ted Harrison

I ONCE went to a lecture on the subject of artificial hips. I don't now recall what was said, but I do remember the title: "What's a joint like this doing in a nice girl like you?"

Spare-part surgery is now commonplace. Underpinning the well-being of many Church Times readers will undoubtedly be an assortment of plastic knees, heart pace-makers, stents, dental crowns, and metal plates, some readers having combinations of these bionic extras.

Physical, as well as spiritual, healing was at the heart of Christ's earthly ministry. Many Christian doctors have seen their medical expertise as an expression of faith; and, in recent years, that expertise has been enhanced by modern science and technology. Those who are not medical professionals are also able to contribute to the treatment of the sick. Donors can give blood to be banked for future re-use by others; and bone marrow can be given to treat leukaemia and other life-threatening conditions.

Giving blood or bone marrow is a relatively minor procedure for the donor; but other forms of donation involve a degree of risk, discomfort, and substantial commitment. Increasingly friends, spouses, and family members are offering to be live kidney donors. Healthy adults need only one kidney, and the spare can be offered safely to someone else. Even though the operation today can be performed using "keyhole" techniques, it still involves a general anaesthetic, plus several weeks of recovery from the surgery. 

TWENTY-FIVE years ago, when I had a kidney transplant, the vast majority of organs were cadaveric kidneys. Today, one senior transplant surgeon told me, 50 per cent of the transplants he carries out involve living donors. Developments in anti-rejection treatments have enabled kidneys that might be less than perfectly matched to be given to recipients with a high expectation of success. This enables donors who are not closely matched blood relations to offer organs as an act of kindness and self-sacrifice. In some cases, when finding compatible organs is difficult, owing perhaps to antibody complications, it is possible to set up chains of donors. In order for husband A to give to wife B, he first gives his compatible kidney to stranger C. Stranger C's friend or spouse, who is a more suitable match for wife B, then gives wife B a spare kidney.

It is also possible for volunteers to offer a kidney to a complete stranger as an act of pure altruism. In addition to undergoing medical tests to determine suitability, they will be interviewed by an independent assessor under guidelines overseen by the Human Tissue Authority, to ensure that they are not being forced to do something against their wishes; or being offered (or accepting) any reward. In some countries, donors sell their kidneys, either legally or otherwise, and cases have been reported of people in dire poverty selling a kidney to clear debts, or to pay for the education or medical treatment of a family member. 

REGULATED and unpaid altruistic donation is an ethically sound act, which a Christian might consider as an act of charity. The identity of the recipient is not normally divulged to the donor (in the same way that recipients of cadaveric organs are rarely told the name of their donor), because of a concern that a relationship might develop between donor and recipient that becomes one of exploited obligation.

The transplant hospital will, however, pass unsigned letters between the two parties. For 25 years, I have sent an annual anonymous letter to my donor family, letting them know I am well. In one reply, I learned that a flowering cherry had been planted in my donor's memory. This has been my inspiration for an artwork I have recently completed for Guy's Hospital, which the transplant team there hopes will become a focus of remembrance honouring all organ donors. 

RECEIVING the gift of a transplant as the result of the death of a stranger is not like receiving a metal or plastic spare part. I can never forget that, running in parallel with my own story of hope and new life, is another: that of a family's loss and grief. Inevitably, I wonder about the donor - who he or she might have been, and how they met their death. It is reassuring to know that, in many circumstances, a family finds comfort in their loss by agreeing to an organ donation, as the parents of Teddy Houlston recently testified. He was the baby who lived only 100 minutes, but whose organs were given to others at his sorrowing parents' insist- ence.

"It is more blessed to give than to receive," Jesus said. To receive a human transplant is a responsibility. Given its high human cost, the gift must not be squandered. The recipient is obliged to do all that is medically required to give the organ the maximum chance of survival; not to forget to take the medication, and not to abuse the body with drink, or junk food. I feel, too, a responsibility not to idle away a life that has been extended in such remarkable circumstances. There is also a sense of guilt and unworthiness to be faced, though without allowing negative feelings to dominate one's thoughts. 

THE Gospel accounts of Jesus's ministry give little advice on how best to respond to being healed. There are numerous stories of miraculous cures, but little is said about what happened afterwards to those who were healed. I can't get out of my mind the absurd image of Michael Palin, in The Life of Brian, complaining that, after being miraculously cured, he had lost his livelihood as a beggar - "Alms for an ex-leper"!

What we do have, however, is the Gospel story of ten real lepers. All were healed, but only one returned to Jesus to thank him. The message is simple: nothing more is expected than gratitude - gratitude to the medical professionals; to the world of science; sometimes even, most of all, to someone whose identity one will never know.

Ted Harrison is a writer, artist, and broadcaster, and was formerly the BBC Religious Affairs Correspondent.

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