Well, I’ll be! I’ve never heard a believer, especially one concerned with social justice, be this dumb and this petulant. I’m referring to Kristel Clayville, who wrote a new piece at Religion Dispatches, “Why I’m not an organ donor“. First, let’s establish that Clayville is indeed a Christian; her bio says this:
Kristel Clayville is a visiting assistant professor of religion at Eureka College and a fellow at the MacLean Center for Clinical Medical Ethics at the University of Chicago. She is also ordained in the Christian Church (Disciples of Christ).
The University of Chicago? That’s my school, and she apparently got her Ph.D in the Divinity School here. And indeed, she is at the MacLean Center for Medical Ethics at the U of C. But her article is an embarrassment to herself, to my University, and to the faith she purports to hold. Her Eureka College biography also notes that Clayville is “an ordained minister in the Disciples of Christ tradition.” (Eureka College is a Christian school in Eureka, Illinois.)
So why isn’t Dr. Clayville an organ donor? In short, because she says the organ donation system is biased towards the wealthy, the well connected, and the educated. And the system is subjective. So she’d rather let people die than save someone’s life who might be in one of those groups.
Of course Clayville realizes that such a stand doesn’t look that good, so she defuses her opponents by going on the offensive
I anticipate some of you saying, “But I thought you were a good person. I thought you cared about people.” And of course you will say this with a perplexed look that suggests you don’t know how I could be so callous, or even worse: anti-science. I know this look well because I’ve been the recipient of it before, usually across a dinner table with my progressive, liberal, overeducated, friends (PLOFs) who suddenly wonder whether they’ve misjudged my character for years.
I’ll leave aside the snarky term “overeducated” (is it possible for someone who likes to learn to be “overeducated”?), and go to her argument, which hinges on “social justice”:
Being an organ donor doesn’t just potentially save someone’s life. You can focus on that aspect of it—and maybe you should—but there are significant social justice issues involved that aren’t apparent on the surface. Among them is distribution—or what the transplant community refers to as allocation. Most of us are aware that there’s an organ shortage, but then who gets a transplant and who doesn’t? And who decides?
. . . But these financial issues obscure a larger problem: to get an organ transplant in the US, you are subjected to medical and social review by a transplant team. This multidisciplinary team consists of surgeons, organ specialists, social workers, nurses, psychiatrists, hospital administrators, and sometimes a chaplain. The medical criteria for getting an organ can be thought of as objective, though also relative to the skills of the local transplant surgeons and the level of risk they’re willing to take. The social review by the team is highly subjective, even in the best scenarios. Since donated organs are a scarce resource, the goal is often to find the best host (recipient) for the organ so that it does not go to waste.
In that environment, organs tend to go to people who can have a full-time caregiver, has family who will help with care, doesn’t take personal risks, and has a medical history of doing what doctors tell them to do. All of these fuzzy criteria require that there is someone on the transplant team who recognizes a potential patient’s behavior as understandable and relatable. Ultimately, these criteria become ciphers for minority status and financial means. Can your spouse take months off of work to take care of you? Mine can’t. Can you afford to pay an in-home caregiver? I can’t.
So the telescopic story is one of free resources and the skills of highly-trained professionals (skills gained with tax-payer subsidies) helping the well-insured and financially well-off overcome diseases and extend their lives, while medically qualified candidates without financial and social means run out of options. From a social justice perspective, this story mirrors the story of the United States in general: most of the resources flow up to the haves rather than trickle down to have-nots.
According to an AP report, “Wealthy people are more likely to get on multiple waiting lists and score a transplant, and less likely to die while waiting for one, a new study finds.” Getting put on multiple transplant lists is not the only way that the haves can get ahead in the current system; they can also move to regions where the organ shortage is not as severe. Doing so can shave years off the waiting time.
Yes, I’m sure there are inequities in the system, and wealthier or savvier people may have a better chance of getting organs. But those who get donations aren’t all that way: I’ve seen enough poor and marginalized people on the news getting a lease on life through new organs to know that the poor do benefit from this system. Yes, it’s subjective, as Clayville says, but it has to be; after all, beyond the medical considerations you’re judging the value of a present and future life, and there’s no objective way to do that. But are these reasons to diss the whole system, one that involves other chaplains, social workers, psychiatrists, and so on?
Apparently so. Because of these inequities, and the “subjectivity” aspect, Clayville will simply keep her own organs after she dies, thank you. (Perhaps she wants to meet Jesus with an intact liver.) But have a gander at her conclusion, which is about as selfish and mean-spirited as one can get. In short it says this: “Because the system isn’t perfect, I’d rather keep my organs and let people die.” In other words, she’s letting people die out of simple spite (my emphasis):
Should you be an organ donor? It’s not mine to say. Organ donation saves lives; it really does. And the professionals involved in organ transplantation are well aware of the social justice issues. Many are working on reforms. In the interim, you get to decide which story you want to be a character in: the microscopic version where you are an organ donor to a particular person in need, or the telescopic version where your organ becomes a resource in an economy that privileges those with financial means.
To return to AJ’s case, it seems that he and his father had been put on the back burner by the transplant team for social reasons. Though the organ wasn’t a scarce resource—it was donated to AJ specifically—their social situation wasn’t recognizable to the team as “normal.” AJ only received the transplant after a significant public outcry. Given that these are the fuzzy social criteria in play, until there’s a significantly revised system of review of transplant candidates I’m keeping my PLOF-y organs.
This is the epitome of social justice gone wrong: because the system isn’t perfect, Clayville prefers to subvert it by withholding potentially lifesaving organs. What kind of Christian is she? When she meets Jesus, will she explain, “Lord, I thought it was better to let someone die than to tolerate the injustices of organ donation”?
h/t: Diane G