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Sunday, August 28, 2011

Kidneys and Culture

Recently a kidney friend of mine told me a story of being approached by an audience member after a speaking engagement she had done. He was with his significant other and seemed anxious to meet her. He introduced himself and explained that his partner was also a kidney donor (but had donated prior to his meeting her). Despite the fact that they were obviously a committed couple, he shared that had grappled with this part of her past as his religion and culture was not supportive of organ donation. The fact she was a woman made organ donation even more inappropriate. As a result, she was, in his eyes, slightly damaged goods.

Now I am as WASPy/white/generic-protestant-sort-of-Christian as they come. For me culture and religion has more impact on the foods I eat and maybe the holidays I enjoy the most, than it does on bigger life choices. Hearing this story made me realize that for some people there is a whole other set of religious and cultural influencers on the decision to donate an organ that I never had to factor in to my own decision. It also made me realize I know nothing about other cultural view points on organ donation. I don't mean so much how they do things in Dubai or  Indonesia etc. but how ethnic cultures and religions here in Canada (or the US) impact whether or not people donate their organs (living or otherwise).

In trying to look into this more I realized that for some cultures and religious groups, there isnt an easy answer. For example, I found a website that lists about 25 of the most common religions or branches of religions you'd find in North America. And guess what-they ALL officially support organ donation. Even Jehovah's Witness, who are frequently portrayed in television shows as being anti blood transfusion (which they are but transplants are officially okay, so long as the blood is drained from the organs first). Most religious groups are pretty clear that it is an "individual's choices should the circumstances make sense". Which is where I think the cultural community steps in and makes its own rules about when organ donation may not be appropriate from a cultural standpoint. In some religious communities, the decision about donation suitability is left to the discretion of the local church on a case by case basis.

In some cultures, donating an organ to someone of another race or religion is also considered taboo. On the other hand, some religions make the argument that by donating so someone outside of your religion, someone who is of your religion waiting on a list will get to move up the list as a result, and be saved sooner (so giving is a good thing). Most religions seem to agree, at least in policy, that helping others is a good thing and should extend to those outside one's own community.

Obviously no religion or culture wants to see its people be unnecessarily harmed. So as it pertains to living donation, most stress that the donation (or receipt of donation) is only permissible if it does not harm the donor (ie giving a heart or full lungs wouldn't bode well for the donor) or cause undue hardship and stop the donor from participating in a normal life (donating an arm or leg). I think its at this point that debates occur within certain communities as to what "harm" mean or what "participating in a normal life" means. I think maybe this is where the man at the beginning of this post and his culture took issue with his partners decision. In his culture, a key role for women is to have children and raise them. And there is a slightly greater risk in pregnancy to any woman who only has one kidney. Pregnancy can impact blood pressure which can harm the kidneys and its something uni-renal women are closely monitored for if they decide to have children. However millions of women do it every year around the world. I do however understand where someone could see the added risk as less than ideal, especially if he was not part of the original decision to make the donation.

Truthfully I am glad I never really had to worry about cultural influences being a part of my decision to donate. I can only imagine the pressure and judgement, deeply rooted in tradition, that some potential/actual donors may have received from their families and communities in some cases. I'm not saying its a good or bad thing-it is just a whole other set of reasons to consider. It is really interesting to read all the resources about how different religions view organ donation. What's also pretty cool is to see how much attitudes have changes in really only the last 30 years. For example, 40 years ago organ donation was not permitted by Jehovah's Witnesses in any way-and now officially they do allow for it. Similar changes in mentality have also occurred in various different Islamic cultures and most interpretations of Jewish law. Again I think it's a question of awareness....the more people learn and understand about both the spiritual, altruistic and medical processes of donation, the easier it is to support and in turn encourage more donors to come forward in that community.

In the end, the reason the gentleman at the start of this post was so anxious to meet the speaker was this: he HAD had lingering feelings that perhaps his girlfriend was damaged goods in some way because of how he was raised and what his culture /religion had influenced him to believe. But with an open mind he had listened to a complete stranger, my kidney friend, tell her own story story (and crack a few kidney jokes) and realized that it was a powerful thing his girlfriend had done. And that she was most certainly not damaged at all.

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