New commenter Christine has a valuable personal experience to relate, as an individual who donated a kidney to a stranger herself. The main thrust of her post covers a topic that I have written on before but did not mention in this case, though I should have. Someone who performs a kind and generous act counting on rewards, copious thanks and gratitude, is doing it for the wrong reasons. The act itself is all that matters. Certainly, gratitude is the right way to respond to generosity, but an act done in anticipation of personal benefits isn’t really altruistic. It is opportunistic. This is a cliché to be sure, but true nonetheless: the generous act must be its own reward.
Here is Christine’s Comment of the Day on the post, Ethics Chess Lesson: The Tale of the Kidney and the Ungrateful Boss.
I want to also commend Christine for following the comment policies, which many of the new visitors here who commented on this post did not do. I prefer full named on posts, but I only require that I am informed of every commenter’s real name and have a valid e-mail address within a reasonable time of their first submitted comment. One way or the other virtually all of the regular commenters here have managed to do this, and it makes a difference, even in my responses. I regard such commenters as collaborators , not just marauders, and most of the time, I treat them accordingly: tgt, Steven, Lianne, Margy, Glenn, Tim, both Michaels, Karl, Neil, Karla, Rick, blameblakeart, Barry, gregory, Eric, Curmudgeon, Eeyore, Julian, King Kool, Joshua, Jay, Tom, Bill, Danielle, Elizabeth, Patrice, Ed, Bob, The Ethics Sage and Jeff…I know there are others. Thanks to all of you for letting me know who you are.
Now, Christine:
“I donated a kidney to someone I’d never met in 2007. At the time, I was working for a small community newspaper. (I was a newbie by comparison. Had only been there a year whereas most of the staff were long-timers.) When some of my co-workers learned of my plan, which involved a trip downstate at considerable expense, they did a series of fundraisers. Overall, I think they raised about $10,000, which paid all my travel and living expenses during my “tour de donation.”
“About 18 months later, I quit the job and I have since completely lost touch with everyone at the paper. Should I have remained there out of gratitude? Without their help, I may have had to back out of the donation.
“I am transient by nature. As such, I have also failed to stay in touch with the recipient. She, likewise, is similarly disinterested because life goes on.
“I have also divorced the man I was married to at the time of my donation, even though he accompanied me on my mission and told me every day how “proud” he was of my donation. I have since taken up with a fellow living donor. (Not that that’s relevant, really. It just is.)
“I experienced a massive amount of depression after the donation. Should I blame someone for that? If so, who and to what extent and what should be my compensation for having acquired this condition?
“Personally, I am embarrassed for Stevens. She undermines her case by sitting for media interviews, crying for the camera, using over-the-top quips, etc. Ethical questions of this nature should not be settled by viewers of Fox News, whose headline reads, “Kidney donor wants organ back from boss who fired her.”
Ethics Alarms 
sorry, if I recieved the gift of life from someone I would be so grateful i would give them MY job. It is simple human gratitide. I wouldn’t donate with expectations of rewards ( I am registered in the bone marrow registry and I give blood) but I wouldn’t want to be punished for it either.
Would you give that person your job if you were certain that they would continue to fail at it until they were fired by the company, resulting in both of you being jobless?
The term: “Ethics Chess” is a misnomer as practicing good business ethics is neither a game, nor does it require strategy or tactics. You simply follow the law and the rules. It’s really that simple. As for the kidney for Brucia case, it is an alarming scenario. There appears to have been an implied quid pro quo here and that is the swamp a jury and judge will have to wade through to get to the truth. The allegations against Brucia are pretty severe, even without the kidney issue. She apparently was a strong X-style manager who psychologically and emotionally abused her employee. Just on this charge alone, there is a good case against her. Atlantic’s response to the situation was typical and improper. A full investigation internally by HR followed by strong corrective action, including a reprimand or termination of Brucia was most likely the correct course of action. Instead they tried to quietly make the problem go away by transferring the injured employee. Employers should never protect a bully.
This is a strong lesson to all employers and employees out there. Do not mix personal feelings and even a charitable act like this with business. This seriously blurs the lines between a personal favor and objective business practice. It can and will land you in court and possibly cost you lots of money.
1. You appear to be metaphor challenged.
2. Ethics and following rules are two different things, though related. Ethics is not like following a recipe book.
3. There’s always a good case when you hear only one side of a dispute. For all we know, Stevens was taking advantage of the situation, goofing off and running naked in the halls.
4.“A full investigation internally by HR followed by strong corrective action, including a reprimand or termination of Brucia was most likely the correct course of action. Instead they tried to quietly make the problem go away by transferring the injured employee. Employers should never protect a bully.” Pure speculation.
5. “This is a strong lesson to all employers and employees out there. Do not mix personal feelings and even a charitable act like this with business. This seriously blurs the lines between a personal favor and objective business practice. It can and will land you in court and possibly cost you lots of money.”
Yup!
I donated a kidney in 2009 to a friend. I did as much research as I could into all potential outcomes for my health. I spoke to people who had donated and I spoke to my doctors. What I knew prior to donating based on the literature on kidney donors (mostly provided by UNOS and OPTN) is that my remaining kidney would become a “super kidney” to pick up the slack for the one that was donated.
No one could give me a definitive answer regarding my insurability post transplant. I got an individual, medically underwritten, major medical policy prior to donating so that if I lost my job at any point in the future, I would still have coverage, because while Ms. Stevens is not technically uninsurable, she will now face massive premiums on individual medical insurance which she needs to get now that she’s out of a job.
What did not become clear to me until after I donated is that I am on my own. All living donors are on their own. The transplant center that takes your organ does not follow your health care, nor are they responsible for it. You sign documents agreeing that you will do follow up with your personal doctor. They don’t tell you what exactly that care should entail. I switched to an internist with a specialty in nephrology so that I can be hypervigilant about the health of my remaining kidney.
Prior to surgery I was told that it could take me up to 4-6 months to feel normal and that it might take up to 3 months to return to work. I dismissed this because all the anecdotal evidence indicated that I would be back at work in just a few days. It was mentioned to me that in a few, rare cases people experienced depression. Again I dismissed this because “I’m not someone who gets depressed”.
In my consult prior to surgery I asked what would happen to my adrenal gland in the procedure and was told “nothing, it stays where it is,” and while this is technically true I was not told that the vessel to the adrenal gland would be ligated, or tied off. Our adrenal system has much to do with how we good we feel, how we manage stress. It’s an important part of the endocrine system. So while the adrenal gland may be left in it’s place it’s also definitely impacted.
While I agree with Christine that Ms. Stevens is not helping her case by crying and making statements like, “I want my kidney back,” I have great empathy for where she finds herself.
It definitely appears that she was coerced or pressured by her employer to make the donation. She was not properly screened to determine whether the decision was being made from a sound place and it appears that she did not that any issues arising from the donation would be hers and hers alone to deal with.
Living organ donation is a bioethical swamp – you have people who are living lives that are more about dying slowly on dialysis with a technology that will change everything over night and give them health and new life. If you love one of these people you will do anything to save them. But now we’ve added in the incredible PR machine that tells the world – you only need one kidney, you’re really healthy and your life will go on as if nothing has changed, your life expectancy will be just as long as if you had two kidneys – and now I see an article, almost every day, about altruistic donors like Christine who are donating organs to strangers at great expense to themselves with no support from the industry that farmed her organ.
The fact is that living donors as a population are not followed medically. No one knows with any certainty whether or not we will lose kidney function as we age to where we too get a diagnosis of kidney failure, or whether we will develop high blood pressure and cardiovascular problems 20 years post transplant. All of these systems are affected by kidney function.
Discovering this after the fact has not made me regret my decision to donate. My friend is doing amazing and the risk is worth the reward, however – I feel that the transplant community is doing a great disservice to anyone who is considering becoming a living organ donor by not 1) following living donors so that they can speak to what the real risks are and help people make FULLY INFORMED decisions and 2) by taking kidneys from people in a situation like Ms. Stevens.
An employee donating to an employer carries a real risk of coercion especially in this economic environment. Ms. Stevens does not appear stable at this point and if that was the case before she donated then someone did not do their job. If her instability is due to depression and anxiety issues post transplant then she’s damaged and there is a moral responsibility on the part of the medical community to make her whole.
Jackie Bruscia is a desperate woman would do anything to stay alive and she’s not alone. There are over 85,000 people on the waiting list in this country who would probably do anything to get a kidney. I just don’t think that most of them would treat another human being the way Ms. Bruscia treated this woman.
She should remember that .what goes around comes around
Susie, thanks for sharing your story. I feel depression just thinking about parting with a kidney. I can’t imagine what I’d feel if I actually gave one away!