Why I bought a kidney

[okarol]

Why I bought a kidney

Dying from organ failure can turn victims into buyers despite outrage over the selling of body parts

Feb 05, 2008 04:30 AM
Stuart Laidlaw
Faith and Ethics Reporter

Twenty years ago, Robert Zurrer was an active man in his early 30s, unwilling to admit that either age or the kidney disease he'd been fighting for five years could slow him down.

Until he played hockey one night.

"I'd play for a few minutes and have to rest for half an hour," recalls the Victoria, B.C., businessman who was in Toronto last week for a forum on illegal trade in body parts. "I shouldn't have been out there. I certainly wasn't any help to the team."

He saw his doctor and was told he needed a transplant as soon as possible. He had managed to avoid dialysis, knowing that being hooked up to a machine three times a week – for the blood cleaning his kidneys could not provide – would put a serious crimp in his lifestyle.

Family members were tested, his sister Carol was a match and a transplant was done within a few months. Four days later, he was on the golf course.

Another mistake.

"I ripped out my stitches," says Zurrer.

Other than needing to be re-stitched, Zurrer felt great. So, 20 years later when the kidney from his sister began to fail, he knew dialysis was not for him.

"Dialysis is a living death," he says.

He wanted another kidney, searched the Internet, followed a few leads and within weeks was in Pakistan buying a kidney from an indebted brick factory worker and putting himself at the centre of a growing ethical debate – the trade in body parts.

Zurrer cashed in RRSPs to raise the $38,600 he needed for the operation and to cover the travel costs for him and his sister Ann, a nurse, to go to Pakistan.

He's not sure how much money the labourer got for the kidney, if any, though he believes he was paid between $1,500 and $3,000.

He made the trip knowing he was embroiling himself in an issue touching on questions of poverty, equality, freedom of choice, turning the human body into a commodity and the ethical struggle to balance the needs of one with those of society.

But when a man faces death, Zurrer says, such questions become academic.

"It's arrogant to tell me I can't do this," says Zurrer, who bought his kidney in December 2006, and equally wrong to tell a poor Pakistani he can't sell a kidney for a shot at a better life.

But after eight years studying the underground body parts trade in Bangladesh, Monir Moniruzzaman sees something different.

He sees his countrymen selling their bodies, bit by bit, to rich Westerners.

"It struck me, how can we sell our body parts? It's like slavery or prostitution – we're selling our bodies," says Moniruzzaman, a researcher at the University of Toronto's Comparative Program on Health and Safety who came to Canada from Bangladesh to study anthropology.

Police in India last week cracked down on an illegal kidney-selling operation in which the organs of up to 500 poor labourers were sold to wealthy patients.

Reports have since emerged of kidneys being stolen from unconscious labourers who were drugged at gunpoint.

Zurrer says his donor was a willing participant. The two met before the operation, and Zurrer hopes to return to Pakistan in the spring to look up the man and make sure he's doing well.

After the operation, Zurrer suffered an infection – which the medical community here warns is common – and low blood pressure. He sought medical treatment once back in B.C. and is healthy today. He doesn't know if his donor had similar problems.

Moniruzzaman says few, if any, donors get followup treatment, since each visit to the hospital costs the equivalent of $10.

As well, he says, few may want to admit they have been involved in the shadowy world of organ selling, which also sees poor labourers selling parts of their livers, lungs and cornea.

It is common for donors to be cheated, he says. Prices can go as high as $5,000, though much of that money is siphoned off by brokers and to pay other costs.

They are often left weaker by the operation, so can find it hard to make a living, he says. Nonetheless, Moniruzzaman was able to collect hundreds of advertisements placed in Bangladeshi newspapers by organ brokers and recipients, enticing the poor to sell their kidneys. Some donors also ran ads.

There are many reasons for selling a kidney, Moniruzzaman says, from debt, to a chance at a new life to needing dowry for a daughter. But he notes the common element is the same: an extreme poverty that lays bare the disparity between donor and recipient.

"A person with a $5,000 kidney cannot be considered the same as a person with $5,000 in the bank."

While selling a kidney can fix whatever drove a person to such a desperate move, Moniruzzaman says it does nothing to address the underlying problems of poverty and exploitation that got them into trouble in the first place.

Of the 33 donors interviewed for his study, only two were better off after the operation. Both bought small farms. Moniruzzaman shakes off suggestions that making the trade legal would end the exploitation, saying the poor in such countries are exploited in lawful industries, as well.

"Poverty and inequity are the problem," he says.

Lesley Sharp, an anthropologist at New York's Columbia University, says such transactions commodify human beings, turning the poor into little more than a source of spare parts for those who can afford to buy them.

"Economic rewards debase us as human beings," she told the forum at UofT. "They inevitably erode the social fabric."

Stephen Scharper, who works with Moniruzzaman at UofT, says once the market is allowed to decide such things, questions of right and wrong will fall by the wayside as supply and demand take over.

"The ethics get emptied out," he says.

He sees in the body parts debate a classic ethical dilemma between obvious benefit to one person – Zurrer got a new kidney – and the implications for society as a whole.

"We see this all the time with debates over such things as torture," says Scharper, an associate professor of anthropology.

"What do you do when you've got a terrorist with a dirty bomb and he's threatening to blow it up?"

Few people support torture generally, he says, but many waver on the issue when faced with an immediate threat.

"It goes to that gut emotional response, and it is absolutely the wrong way to make policy."

http://www.thestar.com/living/Health/article/300323