Excellent discussion. This certainly made me think more about donation; however, I believe you are wrong to include the effects of chains in your analysis, for two reasons.
Firstly, I don’t see how you can count the benefit of all donations in a chain within the donation of the first donor. Sure, those down the chain may not have been able to donate without the original donor, but it is still them that is having a kidney removed, and they should rightly be able to count that within their own ‘charity equivalent’ value. Double counting this donation value for two different donors doesn’t seem correct.
Secondly, I personally wouldn’t want to donate into a chain, as to me it feels like adding additional conditions to the donation - ‘I will donate you this kidney, as long as you have a friend who is willing to donate to someone else’. I believe that patients on the waiting list for a kidney should have equal rights to donated kidneys, regardless of whether they have anyone willing to donate for them.
I like to think that those friends or family that were willing to donate, but were not a match, would still be moved to donate altruistically if their loved one received a living donor kidney. Although this then puts the choice of when and how to donate on their own terms. (I’m not aware of any stats or studies on whether this is actually the case or not.)
Finally, as other comments have mentioned, I don’t see kidneys and cash as fungible in the same way you do. Whilst most would probably donate the equivalent cost of saving a life to charity rather than undergo major surgery, there is nothing stopping you from doing both, particularly if you employer will cover your time off work at full pay. I think AlexanderB has previously made this point quite well.
Excellent discussion. This certainly made me think more about donation; however, I believe you are wrong to include the effects of chains in your analysis, for two reasons.
Firstly, I don’t see how you can count the benefit of all donations in a chain within the donation of the first donor. Sure, those down the chain may not have been able to donate without the original donor, but it is still them that is having a kidney removed, and they should rightly be able to count that within their own ‘charity equivalent’ value. Double counting this donation value for two different donors doesn’t seem correct.
Secondly, I personally wouldn’t want to donate into a chain, as to me it feels like adding additional conditions to the donation - ‘I will donate you this kidney, as long as you have a friend who is willing to donate to someone else’. I believe that patients on the waiting list for a kidney should have equal rights to donated kidneys, regardless of whether they have anyone willing to donate for them.
I like to think that those friends or family that were willing to donate, but were not a match, would still be moved to donate altruistically if their loved one received a living donor kidney. Although this then puts the choice of when and how to donate on their own terms. (I’m not aware of any stats or studies on whether this is actually the case or not.)
Finally, as other comments have mentioned, I don’t see kidneys and cash as fungible in the same way you do. Whilst most would probably donate the equivalent cost of saving a life to charity rather than undergo major surgery, there is nothing stopping you from doing both, particularly if you employer will cover your time off work at full pay. I think AlexanderB has previously made this point quite well.