by Courtney Bither
On June 1, 2021 I donated a kidney to a stranger. Most people want to know, immediately, “Why? Why donate a kidney to a stranger?”
The screening process for kidney donation is thorough, and there are several psychological and social screenings for non-directed (or altruistic) donors. Throughout the process, and in speaking to others about my decision, I’ve come to realize that donating a kidney, while certainly a sacrifice and a very big decision, always felt within the realm of possibility for me.
In my experience, most people who aren’t confronted with organ donation have not spent much time thinking about it. I certainly did not consider myself a candidate for organ donation until a history professor of mine shared with our class that he would be donating a kidney and asked if we had any questions about the process. This conversation prompted me to think more about organ donation: the risks, the benefits, the requirements. And I decided to submit myself as a candidate not long after.
We return to the why: Why donate a kidney to a stranger? The answer is simple: because I wanted to. Because it made sense to me. I decided if I made it through all of the screening, I would be at such little risk for the surgery, and able to contribute so much to someone. So why not?
“Why not?” gave me much more pause than, “why?” Why not give a kidney to a stranger? Because I cannot know anything about the intended recipient, and I cannot choose to whom my kidney is donated. My kidney could go to a child, or a loving parent, or a justice-seeking teacher. Or my kidney could go to a white supremacist—a person’s whose actions I find not only questionable, but evil—a detriment to the wellbeing of others. And my kidney would extend that person’s life.
So how, nonetheless, did I choose to go through with it?
I looked at my options: donate, or not. And I talked through my reasoning with close friends and family—people who understand me and my values, who could help me talk through what felt right for me. Talking out my concerns with each option clarified for me what I was most concerned with: doing good and doing no harm.
I realized, in self-reflection, that I would rather take a chance on doing good, even if it meant harm might result from my decision. It’s uncomfortable to think about, but it’s important to consider. In general, I tend to think that those in need should be given priority over those might take advantage of systems for those in need. I’d rather take a chance on a “good” person receiving my kidney than a bad one. And, beyond this, I can only do what is within my control—the decision to donate is within my control, not the past or future decisions my recipient makes.
Understanding my values here—to do good, to prevent harm, to fulfill what I believe my moral and social obligations are—helped me decide, with confidence, to proceed with kidney donation.
Understanding the gravity of the situation for those waiting for a kidney also helped me decide to donate my kidney: 12 people die every day waiting for a kidney transplant. In 2020 in the U.S., about 100,000 people were waiting for a kidney transplant, and only 22,817 people in the U.S. received one. Not everyone can or should donate a kidney. However, considering the manifold aspects of the issue, more people can and perhaps should think about kidney donation—and other “big solutions”—and where and how they fit in the process.
I am very fortunate to be in a situation where I can donate a kidney: I have very supportive colleagues at work who encouraged me throughout the process; I have enough paid time off for my recovery so I won’t have to struggle financially; I live with my partner and two very supportive roommates who help with recovery while I cannot drive or make food. And for me, kidney donation never felt impossible. But for some people, it does. And that’s alright—even good. Donating one kidney involves much more than one person—each person involved in my recovery made this donation possible. Each “big decision” and “big solution” requires a team—yes, only I donated a kidney, but I couldn’t have done it alone. And what’s more, it’s something that felt right for me, with my values, it was something I wanted to do.
I must admit, at times I feel uncomfortable with the shock I hear from people questioning my choice to donate a kidney. I know people mean well—and I don’t deny, donating a kidney to a stranger is an unusual thing to do—but because donating a kidney was something I wanted to do, I don’t always understand the shock. My favorite responses have come from folks who tell me that they have family on dialysis, so they understand the gravity of the situation, or from those who appreciate that this sort of decision is brave—it certainly required courage. But it isn’t an impossibility—it was a choice I made, and I made it happily.
Everyone can have a role in making the world a better place—in doing good work—and, in my opinion, it’s a good thing that people have different roles in the process. Rather than focus on how impractical another’s role would be for you, perhaps it would be more helpful to reflect on what it is you want to do and what it is that you can do.
You might start by asking yourself, “What do I want to do to make the world a better place? What makes sense to me? And what kind of team or community do I need with me to take action?”
Perhaps will you feel inspired to look into kidney donation (link here), or maybe you’ll sign up to donate blood (link here). Or, maybe you will challenge yourself and a friend to work with an organization like Food for Free (link) or Meals on Wheels (link), working to ensure everyone has access to adequate food in your community.
There are many ways to do good work—to work for a kinder, more equitable world. Find what makes sense to you, what you want to do, and start there.
Not sure what you value or how to make a decision? In my own life, I have found both the Value Sort (link) and the 5 Ds of Good Work (link) useful in my own discernment process (including in my choice to donate a kidney). Be sure to check them out.
Would you like to learn more about kidney donation? I recommend this video and article (link here) from Dylan Matthews at Vox.