In the corner of the medical ethics community where I write, it sometimes feels as though it is taken for granted that organ sale would increase the number of ‘donated’ kidneys. I’ve written before about the uncertainty surrounding post-mortem organ donation policy and there are similarly murky waters around living kidney donation.
In my new paper “A Care Ethics Approach to The Gender Kidney Donation Gap”, I seek to make some sense out of our current situation by looking at donor demographics and their motivations.
Women are more likely than men to become living kidney donors. It’s a curious fact, repeated in multiple studies. This is particularly true in spousal relationships: wives are more likely to donate to husbands than husbands to wives. Moreover, this difference cannot be accounted for purely by the higher levels of renal disease among men.
I call this the Gender Kidney Donation Gap, following a writer from New Delhi, India, who called it the Gender Gap in Organ Donation. It is important to use these snappy titles to describe complex phenomena. We clearly need to do more to encourage men to donate kidneys and I hope that the Gender Kidney Donation Gap could be a way of approaching this.
One reader asked me:
Do we need to encourage men to see donation as a heroic act in order to increase male donation?
I believe the opposite may be true. There is evidence that men are more likely than women to view organ donation as a heroic act. So why do men not donate as often?
Behavioural psychology suggests that people tend to do what they view is normal. On the whole, they will do what is expected of them rather than going above and beyond. If you believe something is a basic duty then you will feel bad if you do not do it; if you believe a course of action is extremely brave act then you do not feel so bad if you elect against it.
It seems that on the whole men consider it heroic to donate a kidney to their spouse. Women, perhaps, on the whole, see it as basic decency. As counterintuitive as it seems, one way to counteract the Gender Kidney Donation Gap would be to promote the view that kidney donation is not heroic but is in fact a normal response to a family tragedy.