I’m a 73-Year-Old Cancer Survivor. Can I Accept a Kidney?

At the age of 52 I was diagnosed with Leukemia. I received chemo/total body irradiation/bone marrow transplant. Now at the age of 68 I am considered free of cancer. I have end stage renal disease and am receiving dialysis. I have decided not accept a live donor's kidney as it may cause problems for the donor in the long run. I am on the wait list and will accept only kidneys taken from cadavers.

Yes, take the kidney. When you are well enough, please volunteer in a hospital, a local school or somewhere else in the community. You are getting an amazing gift - the gift of life. Why not give back?' Also, no one has pointed this out yet: people today are routinely living to 100 or more. This man could possibly live another 20 to 30 years.

The issues about accepting a donated kidney when you have had cancer and chemo are complex. A successful transplant will improve quality of life, and add to the expected lifetime. I do not know how the immunosuppressant drugs for the transplant affect the other systems, or the probability of a return of cancer, but will assume that the doctors have said these are not major worries. Lw1 a says he is 'aware' of potential donors: Who? How? What criteria are being applied to screen potential recipients? How are the connections made? Most important - under what circumstances should the LW1 be given preference over other desperate people? I think that's the real ethical dilemma. A donor's decision to provide a kidney is not an ethical issue for the recipient. It's generous and brave to provide the gift of an organ for a stranger. Unless the donors is coerced or paid, there's no ethical worry here. And - in LW1's place, We all would want a better quality of life - a kidney. On dialysis, LW1 is unlikely to be around in 10 years if it takes that long to get a transplant, and will be in his 80's, when surgery can take a heavy toll. I hope LW1 does get a successful transplant. BUT working out a way to jump the line, so to speak, does present an ethical dilemma. Perhaps the Ethicist might address this: Is it fair to secure an organ before someone else on the list because you have better resources and can get around the Organ Procurement & Transplantation Network rules?

There are simply not enough kidneys to go around, even for 30 year olds.

If you're healthy enough to undergo transplant surgery and you've found a match, don't hesitate. Do it - you have every right to a good quality of life.

Uber Ride: Uber is unregulated even by UBER. Drivers don’t have to know anything including how to communicate with riders. Uber contributes to the massive increase is congestion in the coty. I see drivers cruising around the UWS every day. Empty large black suburbans slowly trolling and sliding through red lights. Drivers looking around or at their digital devices. Who cares? I do the Mayor and the Governor are going to charmed a congestion tax on everyone so Uber can continue making billions....not the drivers..the CEO. We have a taxi commission for a reason. Think about it. Get the Uber (Nd similar) off the road. As for the ticket, no the rider isn’t responsible.

Another example of money being endlessly lavished on old people to give them a few more retirement years. Medicare costs skyrocket, while the health (and teeth) of young and low-income people all over America gets ignored. Talk about misplaced priorities. Give that kidney to a young person who has their life ahead of them. PS. I'm also 73.

In the Uber case, I completely disagree. The driver is far removed from the ethical responsibility here on any ticket issued. That the responsibility was the passenger's who brow-beat the immigrant driver to stop is a given. That the address remember was inputted by the passenger is also a given. That is why I also would hold Uber and Google responsible. It used to be that a taxi driver knew the city, but an Uber driver only has to follow his map. The map was wrong. So they have responsibility here as well. I recently left New York for the Catskills and ended up in Secaucus and assumed I must have done something wrong in following the directions to get onto the New Jersey Turnpike. A night later I was in a bar in the Catskills and got to talking and it turned out somebody that day had the exact same situation. The driver may not have known where he was going but that is tough luck for the passenger who made his choice, and, ahum, sometimes the fates are against you. Here the passenger brags about his wealth. Well Sir, it doesn't buy you out of being civil to the 'help.'

Absolutely no way does the passenger pay the ticket and no way does he have to endure an excursion to Jersey City. It's bad enough he got stuck with an incompetent driver. At this stage Uber owes Alex a little something for his trouble. As to the driver, how about he take a little responsibility. It is his responsibility to know how to operate his GPS. It is his responsibility to have a basic understanding of the city he is operating in. (You don't have to drive in Manhattan very long to figure out the lanes going into the Holland Tunnel). It is his responsibility to be able to read traffic signs, like the dozens of signs he passed that let him know he was in a lane going into the tunnel. It is his responsibility to know how to communicate with his customers. That means speak to, listen to and understand. He is, after all, a *professional* driver. He received a license that says he's a professional driver. He had to pass a test. That test included knowledge of traffic laws. If he can't perform these basic job requirements perhaps being a chauffeur isn't the right career for him.

It's ethical if the donor only wants to donate to you. It's not if the donor would donate to another who is younger and has fewer health risks than you do. I would never accept a kidney at your age that would go to someone younger. It's highly unethical. You have an inconvenience to your life. Someone younger, a child perhaps, would have a lifetime yet to live.

I noticed a conspicuous lack, in the first response, of the costs associated with the kidney procedures. Does it matter if the patient is paying or if Medicare pays? It may sound cruel to prioritize limited resources, but that is the cheesy system we have. As for the last question, is Woman X really Donald Trump?

Get the kidney. Never use uber. Warn your friend.

concerning the letter writer who wants to warn his friend about the manipulative woman seeking to be her friend,how does the writer know that the accounts of her conduct are reliable? I would speak to my friend in these terms: these accounts may or may not be true,but I thought you should be aware of potential trouble and then allow her to make up her own mind.some people form cliques against individuals they don't like or may enlist others to help them spread calumny ,for instance, after a bad breakup.each of us must judge our potential friends in the light of our own life experiences and all of us must be careful not to be perceived as "buddinskis "who can not resist intruding on the lives of others.

Regarding the second question about the Uber driver and Holland Tunnell, why are all the commenters ready to believe the rider, Mr. Ruttenberg, that the driver "spoke little English?" Yes, for many Uber drivers, English is not their native language. But you really need to speak with the Uber driver in the first instance or during the ride. Everything is electronically programmed thru smart phones. I suspect that Ruttenberg is just trying to denigrate the driver in the hopes that a lot of Trump supporters are reading this and will of course take his side! Moreover, do you really believe a person (Ruttenberg) who orders another person (the driver) to disobey the lawful directions of the police! As others have pointed out, the police could have easily mistaken the driver's refusal to obey their orders as something malicious and suspicious, draw their guns and god knows what else could have resulted. Is Ruttenberg really aggrieved? He was the one who programmed in the wrong destination when he ordered the ride and narrowly escaped arrest.

I am quite surprised by the number of people who say LW1 should take the kidney if there's a match. 73 is a ripe old age, one that presumably has given him a lot of joy, laughter, tears, etc. What I mean to say is that it is a full life. Yes, he could live another 10 years, or another 20 years and those might be great too but it's not at all comparable to someone who is, say, 20 getting to live another 20 years. We all have to die at some point. I agree that 73 isn't old but it's certainly not young. There are a lot of ethical problems when people try to extend their lifespans beyond what they're supposed to be. Appreciate the fact that you've lived a full life, and give someone else the chance to live theirs.

Soon after starting dialysis, my mother was offered a kidney transplant at age 87 and turned it down because she felt younger people deserved it more. I don't disagree with her decision on this but she always hated dialysis and decided to stop it 4 years later. She died a month later. If it were me, and I was in my seventies, I would go for the transplant over dialysis.

I have no idea whence you get your information.. In many state, age 70 is the cut-off date for a kidney recipient. I have no idea who told this person that he is a good candidate for a kidney transplant: both age and medical history would seem to be against him. "Damaged kidneys and other systems as well?" Sorry medicallly speaking within the system this gentleman is NOT a good candidate at all. It would seem proper that he discuss this with a team of MDs and possibly a bio-ethicist. Dialysis can be endured.. one can do it oneself at home. There could be major rejection and NO MORE YEARS' at all. The kidney should go to a younger healthier person, wohose body might also reject the new organ. None of us live forever.

If you are medically eligible and one becomes available then you should accept. Patients over 65 years old on hemodialysis have a greater risk of death than those not. This risk dramatically increases with each decade of life. Consider reading the work of Dr Swidler now at Yale, he is a nephrologist and geriatrician and writes about the issues you raise. https://www.ncbi.nlm.nih.gov/pubmed/23051980 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731917/ At any rate, you deserve to live the best life you are able to live. If that means a new organ, then yes, go for it.

Regarding LW # 2, everyone appears to be missing the larger point: Uber, Lyft and the like are nuisances if not menaces on the road. They clog the streets and seen to have no regard for other drivers, pedestrians or bikers. Taken at face value, the writer's experience is a perfect microcosm about what is wrong w/ these services. Driving into the tunnel to head to the WV? Duh! Shouldn't the driver have had the slightest inclination that s/he is headed into another state. Fidi to WV? Take the subway! You would be doing everyone, including yourself, a favor. LW 3. Again, taken at face value, Madam X appears to be a sociopath. They first act nice but soon enough make creative rationalizations to validate their behavior. Studies show that about 1% of the population have this personality disorder (to varying degrees).

As a frequent ride-share app user, it’s pretty obvious that this Uber user, who lives in NJ but was staying in the West Village, inadvertently hit “home” as the destination on the app. The driver was simply following the directions on the GPS to the rider’s home in NJ. Note that the route also shows up on the rider’s App, so it doesn’t matter which language the driver’s GPS is in. Shame on this rider for trying to blame the driver for his own mistake.

Except for one commentator who didn't seem to grasp the implication, nobody appears to have noticed that the kidney patient has a wife. Is that not supposed to matter? I continue to be amazed at the obtuseness of so much of humankind.

Of course LW #2 should have paid the fine. What would he have done if the driver refused to stop, knowing it was against the law, but unable to say so? In all probability, he'd have refused to pay the charge, stiffing the driver.

I have been a nurse in home care and hospice for over a third of a century. Concerning the kidney transplant, the questioner will not get the kidney unless he is a best match for it. If more than one person is a best match and the donor has not specified a recipient, the organization that manages the transplant waiting list that you are on will have an algorithm for choosing the most appropriate recipient. In the past, kidneys were not well matched to recipients and many kidneys were rejected after surgery. Some kidneys do go to people in worse physical shape than the questioner. Perhaps it is because I am from long-lived stock, but I do not consider 73 to necessarily be old. When over two generations ago my father's father died at 75, several of his elders said "Such a young man!" Some recipients had damaged their bodies by illegal drugs. And kidneys are important both for quality of life and simply for staying alive. Your cause of death may be listed as cancer or heart attack or various other ailments, but what makes you die when you do is often the kidneys failing.

I have some knowledge of the Uber driver app so find this situation dubious for a number of reasons. Uber drivers are required to followed the directional instructions provided through the driver app to get to the destination. Drivers do not get to know the destination before selecting to pick up a passenger to minimize the possibility of discrimination. The driver app provides directions in multiple languages because many of the drivers are ESL. If the driver app was instructing the driver to head into NJ in all likelihood the passenger had incorrectly entered his destination to somewhere in NJ. The passenger mentions staying in an apartment in the West Village so it would be safe to assume they are from out of town and may not have the best knowledge of NYC geography. The Uber passenger app gives you a view of the route the driver is taking so the passenger could have verified what was going on. Furthermore, the passenger said the driver arrived after a considerable amount of time. The Uber app provides passengers with an ETA of the drivers arrival and adjusts that ETA if the driver hits traffic or misses a turn. The wait time for the car should not have been a surprise at all to the passenger. Given all of these factors and the fact that it was likely the passenger erroneous destination that lead to being sent to the Holland Tunnel, yes, he would have been responsible for the fine.

How is it allowed that a man who does not have a good command of English works for Uber in NYC, and uses a foreign language app to get around? He should take the time to learn English and also the NYC streets, or else find another job where English fluency is not required. This speaks volumes about the US immigration policy (or lack thereof).

The Uber passenger wonders - "whether I would have been ethically responsible for paying [the driver's] fine? -- His ethical responsibility is to not demand that the driver perform an illegal maneuver - potentially placing other drivers (as well as himself and his family) in danger - and certainly to not demand that the driver ignore direct commands of NYPD officers in favor of his own wishes -- The Bridges and tunnels here in New York City are under constant surveillance considering the possibility of any potential terrorist actions -- and, considering the recent events in Toronto - a vehicle attempting to make an obvious illegal maneuver - while ignoring direct commands from law enforcement on the scene - is not only unethical - but also extremely ill-advised and dangerous -- Mr. Ruttenberg magnanimously points out that he would have paid for the driver's traffic violation -- but one must wonder if he would have paid for the driver's bail and subsequent legal defense (not to mention his own) had those officers chosen to arrest first and ask questions later...

Medically, this is such a no brainer. Of course you take the kidney. You will be dead in 3-5 years without transplantation, with transplant you can add a decade. Your life will be full of worry and time away from your routines on dialysis. Much time will be spent in the hospital. Get the transplant, live longer and with higher quality of life. Resolve any ethical issues of their being someone more deserving out there, somewhere, maybe, by living a good life.

The 2nd case is a cautionary tale about Uber! Take a yellow cab - those drivers (usually) know their way around.

Anyone who drives a car should think so hard every time they get behind the wheel that on this drive they may be the one to hit and kill someone. The streets might have less traffic for maybe about half a second.

I'm appalled that the LW would tell the Uber driver to disobey a police officer. There could have been a tragic outcome to this. What, wasn't the subway good enough for this entitled person? Also, Uber drivers MUST obey the GPS, or they get fired.

I disagree about LW2. If the driver were taking a family to ahospital or there were some other dire outcome of an hour's delay, the passenger should have been very forceful in his request. But LW2, himself, says the only consequence Going RT through the Holland tunnel would have been getting to his lodging an hour later. To avoid an inconvenience, he directed the driver not once, but twice, to pull off. Once the police ordered the driver to keep going to the tunnel, the passenger could, and should, have backed off. Whether he would have paid for the ticket is tangential to the more important issue. LW2 only asks whether he would have been ethically required to pay the ticket, had one been issued. What he should have asked is whether he was acting ethically by forcefully telling the driver a second time to make an illegal maneuver, after the cops had told him to keep moving. He was not only telling the driver twice to make an illegal maneuver, he was also telling the driver to disobey a lawful order by a police officer--which is a far more serious instruction than telling him to pull off in a restricted area. This is a fail by both LW2 and the Ethicist not to raise this aspect of the interaction. The Ethicist obfuscates by stating that an immigrant's encounter with cops could have ended badly.But, guess what, the cops would have been in the right to go beyond a traffic ticket, which wasn't even issued. The cops had more sense and ethics than the passenger. Shame..

Kidney: Of course you Can accept a Kidney But, should you ??? Sure, if you can find your own Donor, fully informed of all consequences and risks. For the record, I'm 58 years old, and do NOT believe that anyone over age 60 should be routinely accepted for donor transplants. There are just too many young adults waiting. And waiting. And waiting. They could live a much improved life for 20 or 30 years with a new organ. Could you ???

If the Uber driver was following GPS instructions to go through the Holland Tunnel, then LW is at fault because he put in the wrong destination address (or for not putting one in when that option is there). He absolutely would have been responsible for the ticket and it was outrageous to demand that the driver pull over.

Regarding the kidney: a hard "no." Unless you are the only genetically suitable donee.

LW2, if you are going to control the driver, and bully him into an illegal act, you should pay any resulting fine. You don't need to get into his status/language, etc. If he was a poor driver, that is on him. You can justify your actions all you like, but you are a bully, and a rich one at that.

The #MeToo movement has brought to light the role of power discrepancies, and it's worth considering that issue in the Uber case. On the one hand, you have an immigrant with limited English skills, who likely has limited options for making a living. Most Uber drivers struggle to make a living after expenses, meaning that every ride counts. If his job doesn't go well, he stands to lose a lot, meaning he was probably easily flustered and influenced. The passenger, on the other hand, only faces time lost and inconvenience. The price of the ticket is affordable, meaning he may be more likely to take risks that could result in a traffic citation. He also doesn't appear to fear police the way that some immigrants might, meaning he would be more willing to take the risk of getting pulled over--whether he is the driver or someone else. I agree that writing a negative review for the driver is in order, as it serves no one to have a incompetent driver working for Uber. But he should be responsible for the traffic citation. The driver was vulnerable, the passenger was in a position to bully, and bully he did.

I disagree with your suggestion that the Uber passenger wasn't responsible for paying the ticket. This seems to be a common quandary in Uber rides. A person hiring Uber drivers is well aware that they aren't hiring a professional taxi driver. They get the benefit of the cost savings and they are responsible for their orders to the driver and their decision to hire them. Further, this passenger ordered the driver to ignore the police instructions, taking advantage of the Uber 's inexperience in driving and in their dealing with US police. I have heard of this quandary before. One of my friends did the same kind of thing, except that that driver got a ticket and my friend did not pay it. This abuse of the poor and ignorant by those wealthier and better educated is a son and a shame.

My husband is in essentially the same position as the writer with the kidney dilemma. My husband is preparing to receive a kidney infected with Hep C. There are a number of transplant departments doing this procedure now. Otherwise transplantable kidneys with Hep C were just thrown away until drugs were developed to cure Hep C. I believe that all the hospitals doing this procedure are still doing it on a "trial" basis. We were also told that, generally speaking, good kidneys were not given to people over 70 (my husband is 75). So we looked at trials giving Hep C kidneys to those over 70. In the Johns Hopkins program, no transplant has failed due to Hep C. MGH and PennMedicine also have programs and probably a number of other sites.

I donated a kidney 3 weeks ago in a paired exchange that netted kidneys for 4 people dying of kidney failure, and maybe more, if the chain continues. On April 21, 438 living organ donors gathered in Chicago in order to set a world record. Living organ donation is more visible than it ever has been! Kudos to the Times for covering this discussion! And you gave proper ethical advice. Great job.

My father had a kidney transplant at 72 after being on dialysis for 6 years from a donor who died in a way we do not know. He is now 80 and healthy. His quality of life after the transplant is immensely greater. The recipient of the other kidney, whose operation was performed at the same hospital, died a few days after my father was released. She was only 55 . My father only spent 3 days in the hospital. I encourage people to become donors. It makes a world of difference for those who survive and regain their health. At 80, my father still works part time.

I never cease to be amazed at how little faith people seem to have in their own judgments. In particular, concerning the person who is struggling with the quandary over whether or not to accept a kidney which a donor had offered, I wonder whether ethics was really his first consideration in making his decision whether to "accept" the donation. So in your generally bloodless manner of discussing life and death decisions, you remove any semblance that you are considering something affecting human beings. You did not address the time when dialysis will no longer be an option as a treatment. So, in my opinion, I believe his doctor should have been the first to consult. However, perhaps he believed that the less the officials knew the better. Perhaps the kidney availability would have to be placed on a list so thge longest waiting, or the most worthy, would have first opportunity. The medical/governmental complex tends to make life impossible for us humans. Second is a close tie between his priest, if indeed he has one, and his wife, or perhaps whether or not to discuss this with her is another ethical question he's postponing. I really can't imagine…perhaps children, syblings, or guru would come before you, my friend. As far as I know, there is no penalty for making a wrong decision in life, if one has already died. The man should do whatever he can to continue what he sees as a contributing time on earth. I don't believe I have much to contribute and I will soon be 71.

My friend, Forrest Lewis, had a liver transplant, but died ten years later, anyway. His quality of life during that time was not good, and required many visits to the hospital. This is something else to consider before accepting a transplant.

From a totally macro perspective with complete information, it seems wrong to use a perfectly good kidney on an "old" person when a "young" person can get much more use out of it (all else equal). If the kidney could be passed along after the "old" person dies, it wouldn't be as much of an issue. Donated kidneys are a scarce resource, and society should seek to use them to their greatest potential. That said, we don't have complete information, so we can't confidently use the donated kidneys to their greatest potential. All we have are statistics. A young recipient might die before the old recipient who would have gotten the kidney instead - either from something related to the kidney need or from being hit by a bus. Both might outlive the kidney. But that doesn't get into the quality and benefit of life with the donated kidney. What if one of the potential recipients would go on to cure AIDS, or otherwise save humanity? What if one of them would go on to be a serial killer? The decision to accept or decline may alter the course of the world! I added the third paragraph just to highlight that there's so much we don't know and can't really control and illustrate some of the futility of confidently predicting outcomes. It's complicated. If you don't feel comfortable taking it from someone else who (also) needs it, let that someone else have it.

Regarding the Uber driver, I am finding more and more that they are relying on apps that are giving them incorrect information. The directional apps do not always work well in NYC, because the streets, avenues and highways are so close together, and sometimes are running on top of each other. The result is sometimes directions that make no sense, and are obviously incorrect. The long-term resolution of this is that Uber (and other app) drivers should be licensed, and, in order to be licensed, they must have at least a rudimentary understanding of the local geography. Clearly, a driver that was willing to go through the Holland Tunnel to get from the Financial District to the West Village had no clue where he was going, and should not have been a driver for hire to begin with. The letter writer was stuck in a situation with no good options.

Disagree on the Uber case. The passenger should have paid for the ticket if one had been issued since he insisted that the driver follow his command. Maybe the passenger should take car service or a taxi in the future instead of Uber.