My logic is (deferring judgment to medical professions) just the amount of effort and money that is spent on facilitating kidney donations, despite the existence of dialysis, indicates that experts think the cost/benefit ration is a good one. One reason I feel safe in this deference is because the field of medicine seems to have strong “loss aversion”. I.e. Doctors seem strongly concerned about direct actions that cause harm, even if it is for the greater good.
The cynical story I’ve heard is that insurance providers cover it because it is cheaper than years of dialysis and doctors provide it because it pays well. Some doctors are hesitant about it, particularly for non-directed donors, but they aren’t the ones performing it.
I do think that is overly cynical: there are clear advantages to the recipient that make transplantation very desirable. Dialysis is a pain, and not without its risks. Quality of life definitely goes up. Life expectancy probably goes up a fair bit too. If I had to make a guess, I’d guess donation produced something like 3-8 QALYs on average for the primary beneficiary, at a cost of about .5 QALYs for the donor. That is a pretty reasonable altruistic trade, but it isn’t saving a life at the cost of a surgery and a few weeks recovery.
The cynical story I’ve heard is that insurance providers cover it because it is cheaper than years of dialysis and doctors provide it because it pays well. Some doctors are hesitant about it, particularly for non-directed donors, but they aren’t the ones performing it.
While that’s certainly a possibility, some evidence against that perspective is that many countries (UK, DK off the top of my head) have introduced altruistic/non-direct kidney donation in the last decade.
Interestingly, I think the Danish Health-board may have a perspective closer to you, in that they have set the minimum age of altruistic kidney donation to 40 years old. I was a little bit frustrated when I discovered this.
One thing I would say (again, without knowing much) in dialysis does sound intuitively a lot worse than having a transplanted kidney, because you have waste products building up in your body for days at a time.
The cynical story I’ve heard is that insurance providers cover it because it is cheaper than years of dialysis and doctors provide it because it pays well. Some doctors are hesitant about it, particularly for non-directed donors, but they aren’t the ones performing it.
I do think that is overly cynical: there are clear advantages to the recipient that make transplantation very desirable. Dialysis is a pain, and not without its risks. Quality of life definitely goes up. Life expectancy probably goes up a fair bit too. If I had to make a guess, I’d guess donation produced something like 3-8 QALYs on average for the primary beneficiary, at a cost of about .5 QALYs for the donor. That is a pretty reasonable altruistic trade, but it isn’t saving a life at the cost of a surgery and a few weeks recovery.
While that’s certainly a possibility, some evidence against that perspective is that many countries (UK, DK off the top of my head) have introduced altruistic/non-direct kidney donation in the last decade.
Interestingly, I think the Danish Health-board may have a perspective closer to you, in that they have set the minimum age of altruistic kidney donation to 40 years old. I was a little bit frustrated when I discovered this.
One thing I would say (again, without knowing much) in dialysis does sound intuitively a lot worse than having a transplanted kidney, because you have waste products building up in your body for days at a time.