The Big Donor Show where an alleged dying woman was going to choose a patient to receive her kidneys was beforehand called unethical, bad taste and much else by politicians, media, patient organisations and doctors.
A Hoax
Last Friday the show was aired after having received massive media coverage. Following more than an hour's suspense and nausea, the time had come for the donor to reveal her choice of winner. Just then the host announced that they were not going to give away a kidney anyway. Giving kidneys away as a prize at a reality show was going too far, even for this show's producers. The host also revealed that the 37-years old "donor" was in fact an actress. All of a sudden it turned out that the entire show was a hoax where the producers, "donor" and the three terminally ill contestants knew that there wasn't going to be a kidney prize awarded during the show.
Publicity on organ shortage
According to the producers BNN, who also launched the Big Brother concept, the aim of the show was to get publicity on the shortage of organs in Holland. They got what they wanted: massive publicity not only in Holland, but also all over Europe.
All Dutch are now well aware of the fact that 200 people in Holland die each year while waiting for a kidney, and the average waiting time is more than four years. There is a massive shortage of kidneys and other organs in Holland and in the western world. Some receive an organ in time, others choose to receive an organ from a third world donor, and others die while waiting. Patients who choose to pay large sums for an organ presumably close their eyes regarding the ethical dimensions of this business concept, as trafficking in human organs is big business and efforts are being taken to prevent, combat and punish this practice.
Fantastic stunt
Nonetheless, the whole TV-reality show leaves a disagreeable taste afterwards. Are the three contestants winners or losers? The producers will say that there are no losers, only winners as the show wanted to inform about the shortage of organs. One of the producers said that the aim was to solve a problem that shouldn't be a problem, namely shortage of organs. The Dutch Education Minister Ronald Plastertek called the show a "fantastic stunt". Some kidney patients on waiting lists also hailed the program's efforts to put this issue on the agenda.
The timing is brilliant. EU just launched a Eurobarometer survey in May 2007 on "Europeans and Organ donation".
The overall result of the survey is that the more awareness, the greater the willingness to donate organs. An exception to this rule is Germany where organ donation is readily discussed, but very often resulting in a rejection of becoming a donor. EU Health commissioner Markos Kyprianou joins the choir of calls for more organ donations in Europe. Therefore the commission is now suggesting that EU-citizens in the future should bear an organ donor card; today 12% have a card.
Donation dilemmas
The shortage of organs and donors is a serious dilemma with global consequences such as illegal organ trafficking. But there are other dilemmas concerning donations, which the donor show, and others seem to forget or choose to repress.
Patients waiting for an organ are of course desperately hoping for an organ and a successful transplantation. In their desperation they are willing to go far in search of help, even to buying organs from impoverished people.
Doctors also have a difficult job in setting up criteria for waiting lists. Who should have the organs? Who should be at the top of the list and who at the bottom? Should it be according to the principle of first come, first served? Or should the queue take survival chances into consideration? Should a fit person come before an overweight person, youth before a middle-aged, a CEO before an unemployed, a parent to young children before a single and so on. Another question is what steps are doctors willing and permitted to take to obtain organs?
Donors and their closest relatives are also faced with dilemmas. Are we obliged to donate our organs, because otherwise two Europeans die daily on account of lack of organs as the case is today? Is it a question of humanity and being a good Samaritan?
Most will donate an organ to their children, but what if a grandparent of 70 is in need of an organ? A person who has chosen to be a donor must also be told of the implications for the nearest relatives upon death. The deceased is removed quickly to ensure the quality of the organs and is returned without vital organs. Eyes are often removed and replaced by glass eyes and so on. The sensitive time around a death must be taken into consideration and the facts surrounding donation should be communicated soberly to all parties involved beforehand.
Biomedical companies are actors who are often overlooked, but who have a financial interest in transplantations. Some are known to use harsh -and at times unethical methods - to secure donors.
The debate about organ donation has been activated. It is about organ shortages, but it is also about a serious cocktail of big business and existential dilemmas regarding life and death.
Birgit O'Sullivan
- 1. juni 2007