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agonyaunt2022-01-11 03:14 pm
ermingarden) wrote in agonyaunt2022-01-11 03:14 pm
Entry tags:
The Ethicist: Must I Donate a Kidney to My Awful Brother?
My only sibling, an older brother, is facing kidney issues and may need a donor. I dread receiving a call asking me to fill that role.
When we were quite young, he regularly beat me up, switching to emotional bullying when I was about 11. My parents never thought to intervene. As we got older, distance helped us eventually get along. But in our 50s, when I announced I was marrying, he bullied our mom into rewriting her will to ensure, should I predecease him, that my future stepson would not inherit any of the estate: He would get it all. When settling the estate some years later, he went after more than was justified and showed a marked lack of trust in me. I really don’t think any of his behavior was intentionally malicious — just what he felt he deserved or needed for his own safety. At that point I had enough and stopped interacting with him, except for birthday cards. I’ve politely laid out my feelings in a letter; he eventually acknowledged he may have made “some errors.” But that’s about it.
What’s my ethical responsibility? If it were one of my close cousins needing a kidney, I would most likely be fine with it. But for someone who has never been able to provide, undoubtedly because of his own childhood trauma(s), a “normal” brotherly relationship, I think this would raise old feelings of being his victim. Name Withheld
Every year, thousands of people in our country donate a kidney, and we rightly honor them for that act of generosity. The procedure itself involves some discomfort (a small percentage of people will have long-term pain in the affected region), and it typically takes a few weeks to recover fully. There’s some evidence that donors have an elevated, albeit still low, lifetime risk of kidney failure. Still, the overall medical risks to donors are small, while the benefits to the recipients are typically huge — their lives can be extended by many years. Because of your genetic proximity to your brother, there’s a good chance that your tissues will be well matched, and a well-matched donation will significantly increase the chance of long-term success.
In the light of these facts, some people will see an easy choice here. For them, the key fact is that, if you prove to be histocompatible, your brother can have a longer, better life at little cost to you. Given that you two are brothers, in fact, they may believe that you have even more reason to do it; they may say it rises to the level of a duty.
Oddly, though, utilitarians, who think that morality is a matter of maximizing the good consequences of your acts, are unlikely to agree — because you could probably increase the good done in donating your kidney by looking for a recipient who’s younger than your brother. (And maybe someone who’s nicer, too — extending the life of nicer people contributes not just to their welfare but to the welfare of those they interact with.)
You wouldn’t have written, however, if you thought that all you needed to do was to measure the consequences of this donation. You’re troubled because your brother is . . . well, he’s your brother. And you think — rightly, in my view — that this relationship is relevant to what you should do. Morality doesn’t just permit you to give special consideration to the needs of those with whom you have certain relationships; it requires that you do so. Most people would agree that your brother has a special claim on you. To be sure, kidney donation is not ordinarily a duty. Even if you were on the warmest of terms with your brother, that fraternal claim wouldn’t mean you had a duty to give him your kidney. The donation would still be an act of “supererogation,” something above and beyond what was required.
If being on warm terms doesn’t convert this fraternal claim into a duty, the question arises of how to weight this special claim if you’re on lousy terms. When a responsibility arises from our relationships, does it derive from the fact that we value them? That condition doesn’t hold here: You don’t much value the relationship. Some have argued that we have obligations to our kin simply because they are our kin. But then is it the bare fact of biological relatedness that matters, or is it the fact of being connected through family relationships, so that the duties extend to adopted members of our family? And, if the latter, do we have no obligations to biological kin who were adopted into other families? It’s easy to get lost in this thicket of issues.
In your case, I find myself moved by two thoughts. One is that you’re not the selfish type — you would probably be willing to donate a kidney for a close cousin. Your reluctance here arises from the fact that your brother has been a jerk to you over the years. And whatever your duties are to your brother, there is something ethically troublesome about refusing to help him because it would, as you put it, “raise old feelings of being his victim.” Let’s grant that he has treated you very badly and never apologized adequately for doing so. You have been, in that sense, his victim. But why shouldn’t an act of generosity to someone who has mistreated you make you feel magnanimous instead?
The question isn’t so much what you owe to your brother as what you owe to yourself. Choosing to deny him a life-extending opportunity because he has been rotten to you would be understandable. It would also be ungenerous enough that you shouldn’t want to be the kind of person who would do it.
When we were quite young, he regularly beat me up, switching to emotional bullying when I was about 11. My parents never thought to intervene. As we got older, distance helped us eventually get along. But in our 50s, when I announced I was marrying, he bullied our mom into rewriting her will to ensure, should I predecease him, that my future stepson would not inherit any of the estate: He would get it all. When settling the estate some years later, he went after more than was justified and showed a marked lack of trust in me. I really don’t think any of his behavior was intentionally malicious — just what he felt he deserved or needed for his own safety. At that point I had enough and stopped interacting with him, except for birthday cards. I’ve politely laid out my feelings in a letter; he eventually acknowledged he may have made “some errors.” But that’s about it.
What’s my ethical responsibility? If it were one of my close cousins needing a kidney, I would most likely be fine with it. But for someone who has never been able to provide, undoubtedly because of his own childhood trauma(s), a “normal” brotherly relationship, I think this would raise old feelings of being his victim. Name Withheld
Every year, thousands of people in our country donate a kidney, and we rightly honor them for that act of generosity. The procedure itself involves some discomfort (a small percentage of people will have long-term pain in the affected region), and it typically takes a few weeks to recover fully. There’s some evidence that donors have an elevated, albeit still low, lifetime risk of kidney failure. Still, the overall medical risks to donors are small, while the benefits to the recipients are typically huge — their lives can be extended by many years. Because of your genetic proximity to your brother, there’s a good chance that your tissues will be well matched, and a well-matched donation will significantly increase the chance of long-term success.
In the light of these facts, some people will see an easy choice here. For them, the key fact is that, if you prove to be histocompatible, your brother can have a longer, better life at little cost to you. Given that you two are brothers, in fact, they may believe that you have even more reason to do it; they may say it rises to the level of a duty.
Oddly, though, utilitarians, who think that morality is a matter of maximizing the good consequences of your acts, are unlikely to agree — because you could probably increase the good done in donating your kidney by looking for a recipient who’s younger than your brother. (And maybe someone who’s nicer, too — extending the life of nicer people contributes not just to their welfare but to the welfare of those they interact with.)
You wouldn’t have written, however, if you thought that all you needed to do was to measure the consequences of this donation. You’re troubled because your brother is . . . well, he’s your brother. And you think — rightly, in my view — that this relationship is relevant to what you should do. Morality doesn’t just permit you to give special consideration to the needs of those with whom you have certain relationships; it requires that you do so. Most people would agree that your brother has a special claim on you. To be sure, kidney donation is not ordinarily a duty. Even if you were on the warmest of terms with your brother, that fraternal claim wouldn’t mean you had a duty to give him your kidney. The donation would still be an act of “supererogation,” something above and beyond what was required.
If being on warm terms doesn’t convert this fraternal claim into a duty, the question arises of how to weight this special claim if you’re on lousy terms. When a responsibility arises from our relationships, does it derive from the fact that we value them? That condition doesn’t hold here: You don’t much value the relationship. Some have argued that we have obligations to our kin simply because they are our kin. But then is it the bare fact of biological relatedness that matters, or is it the fact of being connected through family relationships, so that the duties extend to adopted members of our family? And, if the latter, do we have no obligations to biological kin who were adopted into other families? It’s easy to get lost in this thicket of issues.
In your case, I find myself moved by two thoughts. One is that you’re not the selfish type — you would probably be willing to donate a kidney for a close cousin. Your reluctance here arises from the fact that your brother has been a jerk to you over the years. And whatever your duties are to your brother, there is something ethically troublesome about refusing to help him because it would, as you put it, “raise old feelings of being his victim.” Let’s grant that he has treated you very badly and never apologized adequately for doing so. You have been, in that sense, his victim. But why shouldn’t an act of generosity to someone who has mistreated you make you feel magnanimous instead?
The question isn’t so much what you owe to your brother as what you owe to yourself. Choosing to deny him a life-extending opportunity because he has been rotten to you would be understandable. It would also be ungenerous enough that you shouldn’t want to be the kind of person who would do it.
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yeah, my thought on this was the same as yours, much less wordy than the Ethicist's. "Don't give this guy so much as a tonenail clipping. Then find out about registering to donate a kidney -- or something less intrusive, like getting on the marrow registry -- to a stranger."
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And leaves you with one kidney and a close family history of kidney disease.
Apparently I'm extra petty and vindictive this week, because I'd tell the awful brother that I am never giving him a kidney and that I've updated my will to ensure that should I predeceased him, my kidney goes to literally anyone else, including a nephrology dissection lab, before it goes to him.
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(Hearty agreement.)
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...What?
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I prefer "sorry not sorry, asshole, but I wouldn't piss on you if you were on fire"
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Normally "give up an internal organ" is a byword for things we are NOT morally obligated to do! Also the brother's a fucking asshole and deserves nothing at all from a person he's abused, but even if they were on cordial terms an ORGAN DONATION is still not something that a person can be expected to do as a matter of course Because Family.
Also, of course, it's a risky medical procedure, with long-term consequences. But even if we lived in safer times and it was completely routine with little risk of complications... still not obligated. Those are LW's organs. Not communal assets.
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Like, I would happily do it for someone I loved - giving a kidney to my friend would have been totally selfish, I would have done it because I didn't want to lose him - but it is a *hell* of an ask for someone who has never been kind to you!
Plus, you know, you are the boss of your internal organs, no one has the right to demand that you give away a piece of your body.
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Also, being pressured to donate not only an organ but undergo general anesthesia, weeks of recovery and pain, and further risk to someone who abused you is Not Okay. Brother wasn't just a jerk, he was an abuser. He continued to try to take advantage of LW over the years. Fuck him and his kidney. He can get a cadaver kidney if he's lucky.
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Quite - and surely all these issues are actually very thoroughly gone into before any donation happens, it's not just a case of boogeying up to the operating theatre and having one of your precious inner organs whipped out and put into your horrible brother. I think there may even be psychological counselling?
In fact, since at present the question is only a maybe, and he hasn't (yet) even asked, I think she should be in therapy over this to stop beating herself up.
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Nitrates in drinking water = kidney issues. It could explain why brother has kidney issues, and if it does, LW is at high risk of kidney issues.
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This is NOT the situation LW is in...
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Or you're on a living donor list because you want to be a living donor and get called up to donate, the stars align, and you're in the correct circumstances to go through with living donation.
But no one should donate under duress (and iirc there are screening measures in place to prevent this from happening)
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Forgiveness for a lifetime of shitty behavior.
Blessings for the continuation of whatever kind of behavior the brother wants to perpetrate, shitty or not.
A direct line to their conscience.
Emotional blackmail power.
Just to name a few. If you think you can give all of that to your brother, LW, then go ahead and throw a
cherrykidney on top. But my guess is that you don't want to do that. I sure as hell wouldn't.no subject
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a) what the FUCK
b) that last paragraph REEKS of "technically you can get away with being a mean selfish horrible person, but you knowwwww you want to Do The Right Thing", which gives me the heebie-jeebies
c) kidney donation is not trivial and is in NO WAY a requirement for Being A Good Person
d) *possum scream*
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If I were this guy’s friend I’d tell him to tell his doctor that he’s being pressured to donate. The doctor will then report that he’s not a match.