Dear Prudence: My BIL needs a kidney, my husband doesn't want me to donate mine

[minoanmiss]

Q. Life-or-death decision? My brother-in-law is in desperate need of a kidney and has been approved for being on the list to obtain a cadaver kidney. However, the expected wait time for him is longer than he’s likely to survive on dialysis. His best chance of survival is to obtain a kidney from a living donor. I’m one of the few people in his life healthy enough to be a donor. I’ve contacted the hospital to ask to be tested to see if I would be a compatible donor. In discussing and researching the issue, I suspect there’s a reasonable chance I’ll turn out to be compatible. My husband is adamantly opposed to my being a living donor for my brother-in-law and does not want me to even be tested. To put things into context, I tend to go overboard in doing things for others—as my brother would put it, I have a “savior complex.” Over the years, I’ve begun to realize I overdo it to the extent of sometimes negatively impacting our lives, which understandably irritates my husband, and I’ve worked hard at scaling back.


Second, this brother-in-law is not our favorite person. We disagree on pretty much every political and religious issue, but more importantly, he’s just not a kind person anymore, having become judgmental and critical as well as controlling of my sister. He wasn’t like that years ago, and the 30 years he’s spent dealing with this serious illness probably has a lot to do with the change in personality. Unfortunately, my husband never knew him before he became ill, has only ever seen this side of him, and strongly dislikes him.

I don’t know whether my husband is bothered by who I’d be donating a kidney to or if he’s afraid it’ll be a problem for me to live with just one kidney. At this point, I’m punting the decision, telling him I’ll go forward with being tested because if I’m not compatible, there won’t even be a decision to be made. If I turn out to be compatible, we’ll make a decision together at that point. If he continues to oppose it, though, I really don’t know how to deal with it. I can’t imagine letting my brother-in-law die if I could prevent it, yet know doing it without getting my husband’s agreement would permanently affect our relationship. We’ve been together for over two decades, get along amazingly well, and I surely don’t want to ruin what we have. How do I convince my husband and/or decide between my brother-in-law’s life and our relationship if I can’t convince him?


A: The question of how your health and quality of life might be affected by a possible kidney donation is one you can get real, practical answers on, by speaking to a doctor before, during, and after testing for compatibility. Potential donors aren’t just screened for the health of their kidneys, but evaluated pretty thoroughly by a team whose sole priority is the donor’s safety. I’m curious how, or whether, you see your current situation as part of a “savior complex.” What has “scaling back” looked like over the years? Would your husband agree that you’ve scaled back significantly, or do you two differ? Has your brother-in-law ever asked you to donate a kidney? Have you two ever discussed the possibility? Does he know that you’re getting tested for compatibility? Where did the idea come from, and whom have you discussed it with besides your husband? If you’re not sure about the nature of your husband’s objections, you can ask him flat-out: “Are you more concerned about possible health risks if I make the donation? Or are you bothered by the fact that it’s my brother-in-law?”

If you do not move ahead with kidney donation, it does not mean that you will be personally responsible for your brother-in-law’s possible death. I also think it’s possible for you to have loving, thorough, respectful conversations with your husband about the situation and ultimately say to him, “This is really important to me, and I’m going to move ahead with testing even if you disagree.” Both options are available to you, and there are good cases to be made for either side. My strongest advice is this: Punting is going to stop working at a certain point, so you need to figure out what you want, what risks you are and aren’t willing to run, what you think might be motivating you, what outcomes you fear the most, and what outcomes you desire the most (not to mention thinking about other ways you can offer your brother-in-law, and your sister, love and support). And don’t frame this as “my brother-in-law’s life” versus “my marriage”—you are not the only thing standing in between your brother-in-law and death, and it won’t help you make a decision if you start thinking of yourself as his only hope in the world. Good luck.

Comments

[lemonsharks]

Man, I wish we knew which political and religious issues they "disagree" on, and in what direction. Because that would changes my answer.

I would not donate so much as a cup of plasma to most conservatives even if they would die without my specific plasma, and I would in fact flip them the bird as they lay there croaking. Because I've spent the last twenty years watching them get more and more radicalized, to the point where "mainline democrat" is the absolute most conservative a person I can tolerate in my day to day life.

(I'm out of sympathy for people who want me and my loved ones dead, enslaved, or worse.)

But like ... if the OP and her husb are republicans or republican adjacent? Especially if they're Christians? I'd say suck it the fuck up and live by the tenets of your goddamn religion, and that SIL's relationship is between her and BIL.

[minoanmiss]

Yeah, I was thinking much along these lines. Although, whatever her affiliations, I think LW needs to let go of the idea that Only SHe Can SAve The World/the BIL.

[shirou]

I don't know anything about the risks involved in kidney donation, but assuming they are more than negligible, I understand the husband's concerns. He and LW still have decades of life together, and that's a lot to jeopardize. I'm assuming there are no minor children in the picture, as that would be a bizarre omission; if the LW does have children to care for, that's a major factor in this decision.

Danny (Prudence) suggests LW ask her husband, "Are you more concerned about possible health risks if I make the donation? Or are you bothered by the fact that it’s my brother-in-law?"

Surely it's both. The health risks are the main concern, so the question becomes, will you take the risk for this particular individual? Most of us don't become living donors for strangers.

[mirlacca]

I've known a couple of people who have donated kidneys, and they've done fine.

This is not to say that there aren't dangers. You don't have to have two kidneys to live. But if you only have ONE kidney and something goes wrong... you have a problem. In fact, you have the same problem the BiL has right now.

I do agree that the OP is not the only person standing between the BiL and death. Also, since it IS a BiL, not a blood relative, there's no guarantee that they're a match anyway. I would say, get tested; the OP is right, that might resolve the issue right there. If not, she might consider how many *other* potential matches are out there who need kidneys--what if one of them is, say, a new mother? And what if the next thing the BiL needs is a lung?

[lilysea]

My feeling is that you should only donate a kidney to someone who you deeply love, and who you would risk your life for. Because that is what you are doing.

Also, now that COVID is in the community, and we know that COVID can cause kidney failure, LW may need both their kidneys if they get COVID.

Also, if LW has children, and one of them needs a kidney, how would LW feel about not being able to help their children?

Also, if LW is in the US does donating a kidney create problems with their health insurance going forwards - pre-existing condition.

[lavendertook]

There's phrasing in LW's letter that makes me think she really desperately wants to be talked out of giving BIL her kidney but her values of what a good person is are getting in the way, and she wants to be given other reasons that fulfill her values to not do it. I think your answers are on the right track. Like if this is her husband's brother, there's a good genetic risk he might need a kidney one day, and she won't have one to give him. And there are many people who need kidneys now and throughout her life there will be opportunities to see if one of these people turns out to be someone she and her husband can agree on, someone they both feel is worth risking their lives to help. Also, she said she is one of the few people healthy enough to be a donor, so I'm assuming her husband isn't. There may be some issues there to discuss about his compromised health and how this will affect him as she is his partner.

I'm also with green_grrl that helping BIL does not sound like a good thing for SIL and she should think about giving her a break by leaving them well enough alone and not meddling in this.

LW sounds like she's asking to be saved from herself and the havoc she might wreak on her relationship, and like most LW's she could use some therapy so that she learns how to save herself from herself herself (that was a fun sentence to write!)

[minoanmiss]

"LW sounds like she's asking to be saved from herself"

THAT PERFECTLY ENCAPSULATES MY REACTION. This is the phrasing I needed for the feeling this letter gave me.

(With some heavy dashes of agreeing with lemonsharks's perspective as well.)

[green_grrl]

but more importantly, he’s just not a kind person anymore, having become judgmental and critical as well as controlling of my sister

I can’t believe the response skipped over this, but maybe because it’s harsh. Truth is, give your sister a chance at freedom. If you and your husband think BIL has become an asshole, imagine living with him 24/7. Let BIL slip away; certainly don’t risk your life to continue to make your sister’s life hell.

[lemonsharks]

Oh man, I can't believe I slipped over that.