Kidney payment ethics questions raised

Before Canadians consider paying for kidneys, other options for reducing waits should be carefully considered, a transplant recipient and a bioethicist say.

Woman who waited 9 years for kidney isn't comfortable with payments

Researchers investigate whether paying donors up to $10,000 for their kidneys could help reduce long transplant wait times 2:07

Before Canadians consider paying for kidneys, other options for reducing waits should be carefully considered, a transplant recipient and a bioethicist say.

Helen Sklarz, 60, said the nine years she spent on dialysis were bittersweet.

"It filtered and cleansed my blood and it removed toxins so I could stay alive but it took away my quality of life," Sklarz said Friday. She received a kidney 16 months ago.

Organ donation in Canada has always been routed in voluntarism, says bioethicst Linda Wright. (CBC)

Sklarz inherited polycystic kidney disease from her father. It left her with fluid-filled cysts that were triple the normal size at times.

Dialysis meant being tethered to a machine for four hours, three weeknights a week, which Sklarz said was exhausting. Dialysis can lead to headaches and severe foot and leg cramps. Sklarz also needed angioplasty to clear clogged vessels so her dialysis access site wouldn't be blocked.

She also had to keep a restricted diet. Even the fluid in a bunch of grapes could be too much on a hot day, she recalled.

In contrast, after the transplant,  Sklarz says her life is "incredibly wonderful." She's able to renew old friendships, make new ones, enjoy long weekends away, hike, garden, travel and volunteer — activities she'd severely curtailed before receiving the kidney.

On Thursday, researchers in Calgary published a modelling study that suggested paying $10,000 to living donors would increase the number of transplants performed among wait-listed dialysis patients by five per cent, and would be less costly and more effective than the current organ donation system.

"Our model found that a strategy of paying living donors for their kidneys not only saves money for the health-care system, but that the outcomes including quality of life for patients is improved," said study author Lianne Barnieh of the University of Calgary.

Despite the long wait, Sklarz isn't comfortable with the idea of paying for organs.

"This to me doesn't feel ethically correct," Sklarz said. "There's the potential for so many financially strapped and vulnerable populations to make a rash decision for cash."

Slarz said she'd rather governments ease wait times for people in need of organ transplants by educating Canadians to help overcome fears and encouraging people to register their consent to donate upon death, when organs can potentially save eight lives.

Paying kidney donors is socially divisive and needs to be carefully thought through, said Linda Wright, director of bioethics at Toronto's University Health Network.

"Organ donation has always been routed in voluntarism and altruism and this is changing it in a very fundamental way," Wright said of the proposal.

Iran is the only country where paying for organs is legal.

With files from CBC's Kim Brunhuber and Amina Zafar


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