Kidney transplant patients and the complexities of living donations: an anthropological perspective
Kidney transplantation is depicted by modern biomedicine as the optimum treatment for end-of-stage kidney failure. However, there is a shortage of organs across different countries. The issue of exchanging these limited supplies has been addressed in the Social Science literature. Kidneys have been conceptualized as ‘gifts’ and/or ‘commodities’ between donors and recipients and kidney transplant has also become the focus of discussions in other disciplines, including ethics and human rights (e.g. illegal trafficking of organs and gift-giving). In a context of high demand for kidney transplants and worldwide organ shortage, health care professionals often encourage patients to explore the possibility to receive a kidney from a living donor such as a family member. Despite better clinical outcomes from living donors and shorter waiting time for a transplant, some patients prefer to wait for a cadaveric donor and to remain on dialysis. This paper aims to discuss the complexity of issues emerging when engaging with the decision-making process surrounding living donations. It offers a reflection on the interactions between patients and health care professionals, and how cultural and religious beliefs interact to shape responses to kidney transplantation. By drawing on research in renal units in the UK, I focus on kidney transplant patients’ narratives to provide an insight on the nature of gifting, reciprocity, family obligations and the ethical and moral issues at play in ‘risking the life of a family member’.