Wednesday, May 30, 2007

The Big Donor Show

Just when I think I've seen it all in reality television, Amsterdam, Netherlands has something totally new and off-the-wall. The prize is not $1,000,000 or glamorous trips around the world. The prize? A kidney. Yes, that's right, a kidney.

According to this Associated Press story, the show centers around a person that they're calling "Lisa." Lisa is a 37 year-old with an inoperable brain tumor and subsequent terminal illness. During the show, she will talk with and interact with three individuals who are candidates for kidney transplants.

Producers of the telecast (called the "Big Donor Show") want to highlight the shortage of kidney and other organ donors. One government official would like the Dutch parliament to block the broadcast. A network official had this to say...
"We know that this program is super controversial and some people will think it's tasteless, but we think the reality is even more shocking and tasteless: waiting for an organ is just like playing the lottery," Laurens Drillich, chairman of the BNN network, said in a statement.

He said waiting lists in the Netherlands are more than four years long and 200 patients die annually for lack of a donor.
If that's not bad enough, the article goes on to say that "Lisa's" wishes may not even be observed and carried out...
A spokeswoman for BNN said that there could be no guarantees the donation would actually be made, "but the intention is" Lisa's donation would be carried out before she died.

That is because her wish to donate to a particular candidate "wouldn't be valid anymore after her death" under Dutch donation rules, Marieke Saly said. If Lisa does donate one kidney while living, the other kidney may still be awarded to someone else on a national donation waiting list under the country's organ allotment system.
Wait. It gets even better and more outrageous than that. If you can believe this, government weezels are hesitant to block the broadcast in the following statement in the AP article.
Education Minister Ronald Plasterk, addressing parliament on behalf of the government because the health minister was ill, replied that there were serious questions about whether the transplant would actually go through as BNN has advertised it — but that there was no way to stop the program from airing.

"The information I have right now tells me that the program is unfitting and unethical, especially due to the competitive element, but it's up to program makers to make their choices," he said.

"The constitution forbids me from interfering in the content of programs: let there be no mistake about that, that would be censorship."
Censorship? Are they kidding? Is it censorship to have a game show to determine who gets the kidney of a terminally ill patient? Is it censorship to parade out a terminally ill patient, and have her interview three individuals with kidney failure, only to have her wishes potentially denied?

This is ridiculous and scary if you ask me. It will be interesting to see how this Big Donor Show all plays out. I wonder if network executives in this country would touch a concept like this one. What's sad is that they are probably watching this Dutch story closely to see if there is any public outrage over there. If not so much, then maybe someone in the US would try this stunt of a game show.


may said...

i am speechless about this. and for a girl who loves to talk, that quite sums it all up.

Anonymous said...

Wow! I'm not sure how I feel at the moment after reading this, other than stunned. While it will bring some greatly needed press to organ donation, this certainly is not a good manner in which to convey the information. On a tangentially related topic, just last week I was reading (and I forget which journal/publication I read it), it showed a remarkable decline in the numbers of people who donate their bodies to science. That really surprised me. Should I live long enough, I will have spent more than half of my life educating physicians. I plan to do so after death. To me, it's the most fitting and logical final act in my career as a physican educator. I think it was Nitty Gritty Dirt Band who sang, "Please don't Bury me", ...I'd rather have them cut me up and pass me all around..."
Here's a curiosity question for you docs out there: WHat distinct memories (If any) do you have about your cadaver in gross anatomy?

The Curmudgeon said...

Exploitation sells and the boundaries of bad taste are rolled further back each minute. You're quite correct -- I'm afraid -- that American TV execs will see if the idea can be adapted to American TV.

Dr. Deb said...

I am speechless as well. Good things my fingers can type though.

Anonymous said...

I guess I'm mostly surprised this didn't happen in the USA first.

Perhaps this emphasizes the need for assumed consent laws to boost the number of donors?

Cory said...

I was speechless when I first heard about this as well. Still am, for the most part. But I think that it really sucks that they could make the show, the the government might end up not allowing the "winner" to get the kidney. That's what makes it really bad to me. But at least it is bringing attention to a major problem.

twilite said...

I first heard this on BBC International...thought you might blog this Dr A.

The producers reckon no one watch documentaries but game shows...there is following!!!

How low some tv channels can stoop! What justification to 'freedom of speech'! Sic!

twilite said...
This comment has been removed by the author.
Anonymous said...

As a wife of someone who will be having a kidney transplant soon, I'm totally disgusted by this game show. What gives them the right to play God? What about the other 2 families that don't get the kidney? For them, it would be devistating....I guess they signed up for it and know that already. This should never be allowed to happen. Want to shine some light on the issue of organ shortage....go to Oprah or someone like that. My husband has a kidney disease called Alport's Syndrome. He is 25 and his kidney's are not filtering toxins out of his blood as they should. It is X linked and passed genetically from his mom to him. In each of the one million tiny filtering units (glomeruli) in each kidney, blood is filtered across the glomerular basement membrane (GBM). In Alport syndrome, type IV collagen (collagen 4A5 gene in my husband's case), one of the proteins that makes up the GBM, is absent (my husband's) or abnormal. Although the GBM looks normal in childhood, it deteriorates with time because it lacks the special type IV collagen that should be there. Over time kidney function slowly deteriorates. My husband has lost most of his hearing, has high blood pressure, high cholesteral, and basically is slowly dying in front of me. We have 2 young children and I want them to know their dad. My husband is a VP at a national bank....from the outside everything looks great in our lives...on the inside its a horrible battle that should be brought to light....but not on a game game show that will sensationalize and play God. Sick sick sick!!!!

Anonymous said...

This is one of those "Why am I not surprised" moments. I am not shocked or horrified. I think it is possible that it could be handled with care and dignity and accomplish more awareness if done without exploitation. In life there are no guarantees...very much like this show seems to be saying so far. There is no guarantee that the person who "wins" will see a kidney. There is no guarantee that the ones not choosen will not get a kidney before they die. I am not surprised to see this show being developed, nor horrified that it would be shown. I wouldnt want to see it be a regular installment on TV-but if done right-with the right motives, it really has the potential of having an impact on people that wouldnt watch a documentary or regular type of awareness segment on the news.

Anonymous said...

Well, it may be tasteless, but then again maybe it could do some good. Maybe it will encourage people to think about organ donation. At least they're not getting sold on the black market?

ps- are all her candidates elligible for her kidney??

Bookhorde said...

At first I thought it was appalling, then I heard an interview of the show's producer on NPR ( I think it was from BBC). The producer presented their side interestingly. He talked about a colleague who died some years ago while waiting for a donated organ, and about the lack of donors in the country. He said that the woman, who is dying from cancer, has a right to pick who gets her kidney. He said that for the 3 candidates, they get a 33% chance at living now, much better than their current odds on the organ wait list. Finally he said that in making a controversial show (vs say a documentary) they already achieved one goal by making organ donation a household item of conversation.

the blogger formerly known as yinyang said...

TV kidney competition was a hoax

twilite said...

Whew! A hoax? Bad taste indeed! This is a shot in the arm...attention-seeking?! Soon everyone will forget and back to square one!

To give away an organ is never easy decision unless the sufferer is a loved one. This is human psychology...bad? good?

If it's death, it's ok then why aren't there more organs donated I wonder?

What was the stunt all about? Asking the healthy person to donate and give a part to the suffering now OR till death?

Anonymous said...

twilite, the show was intended to raise awareness of the fact that there are too little donors. There are an estimated 4100 people on the waiting list for kidneys in the netherlands. Of the 16.5 million people living there, 143.000+ people die every year. That's almost 12.000 a month. How is it possible that with 12.000 people dying every single month, there aren't enough donors to provide those 4100 with organs?

4100 people on a 4-year waiting list. Let's assume 1025 people get a new kidney every year. That's 86 people a month. 86 people get a kidney from a donor, yet 12.000 died that month. That would indicate that 0.72% of the people who died had a donor card.


Why do so little people have a donor card? WHY?

There's something horribly wrong with the system - and the government has tried to fix this injustice, but has been thwarted for unknown reasons, mostly from within.

Being a donor, organ transplants, the horrendous insecurity these people have while waiting for an organ are all being debated. I see it all around me, people talking about it, discussing it. I see it on weblogs such as this, on the BBC news site, on CNN's site.

This is what the show was meant to do - start a debate. And the funny thing is, the organ shortage isn't just a Dutch problem - it's worldwide.

It's unfair and shit. But people think too easily - I don't need an organ so screw being a donor. How many people eventually end up receiving a donor organ, thereby living a better and possibly longer life, while never having been a donor themselves?

*shakes head*

Anyone who still says the show was tasteless and disgusting is entirely missing the point. The show was meant to press people's noses onto the facts - make them realize something's wrong, and that it's not going to go away just by going 'LA LA LA' and covering your ears. The show was (in hindsight) never about being a gameshow in which a kidney would be given away. It was meant to allow the viewers to listen to the participants' stories, their lives, the trouble they have to go trhough every single day AS IF it was going to matter for their future.

And maybe it still will.

Bottom line? The show showed how many facets there are in deciding who gets to have a donor organ. How difficult such a choice is, and that no matter which of the three had been chosen, the other two would have been screwed. Now translate it from the show to the real world, where decisions about who gets a transplant are even more clinical and less personal.

There shouldn't have to be a choice. There should be enough donors to accommodate the few who need it.

And the show definitely caused me to regard things in a different way (though I've been a donor since I was 16).

Lin said...

A twit is a baby goldfish. Now you have more information to think about before you decide whether or not you are one.

Nah! Look in the mirror. No long fishy tails. No gossamer fins. I leave the rest of the obs. for you.

Have fun with your latest toy! ;o)

twilite said...

robin: thanks. Obviously you're not a medical person. You're one of those armchair concerned persons.

You've not answered my question: are you asking one to give a part of oneself while he is healthy? Or, when he's dying? Or sudden deaths? Or in accidents?

Statistics are unnerving...but the reality in going for such a major op is equally if not worse.


Carrying a donor's card is easy but to give that to someone while living???

I think in Belgium, everyone is a bone fida donor...

As one grows older, one's health goes

People care...but...the issue or concern is not so simple! There are many variables to consider...can a medical doctor or a specialist enlighten?

Anonymous said...

This show was absolutely disgusting.


Anonymous said...

twilite: That post was written with a heated discussion just behind me, so may have oversimplified. Of course, of the many people dying, their health simply doesn't allow their organs to be used as transplants. Those who aren't old and decrepit are often really sick, and especially cancer patients more often than not are not eligible.

I know it's not that simple.

As far as I understood the show did not ask for living donors per se, they asked for people to consider, get a donor card, but mostly to get a debate going. And that it did (obviously). We now need to move on from the show to the underlying issue.