The third chapter of Dr. Sigrid Fry-Revere's forthcoming new book The Kidney Sellers is entitled "Transplanting Organs and Ideas". This portion of the book is divided into multiple sections, too numerous to name. The author details her arrival at the Imam Khomeini International Airport in Tehran, evaluation by customs officials at the airport, long car ride through Tehran to Mehrabad Airport, domestic flight to Shiraz, experiences at the Homa Hotel, time at the MESOT conference, and two visits to Persepolis (ancient ruins of the capital of the first Persian Empire). Primarily this chapter serves to illustrate Dr. Fry-Revere's initial reactions to the mixed Persian/Arab Iranian culture. From the LIBERTARIAN BIOETHICS BLOGger point of view, the most interesting anecdote was the author's description of Dr. Francis Delmonico's talk at the MESOT conference, in which the Harvard surgeon, in a surreal scene defining the concept of cultural imperialism, lectured the assembled Iranian physicians about "the evils of compensating donors" of kidneys and other organs. The chapter ends with a strong tease about the author's further experiences in the "real" Iran. My interest in this work continues to soar.
The second chapter of Dr. Sigrid Fry-Revere's forthcoming new book The Kidney Sellers is entitled "Getting There". The chapter is divided into the following three subsections: "What the Tour Books Tell You", "Sunni vs. Shi'ite and the Persian/Arab Divide", and "Ancient Roots". In this chapter the author delivers a concise history of Iran.
The "What the Tour Books Tell You" subsection of chapter two provides basic demographic, economic, and geographic facts about Iran and Islam. The historical significance of the power of the Iranian State in the Middle East is emphasized. The fact that the "going rate for a kidney in Iran is the equivalent of about $5,000" whereas the "average individual income in Iran in 2009 was a little over $3,000 per year" explains the primary motivation for many Iranian kidney sellers.
The "Sunni vs. Shi'ite and the Persian/Arab Divide" subsection of chapter two is very short, only three paragraphs long. It seemed to me that this subsection should have started earlier, for some of the previous subsection also detailed the Sunni/Shi'ite and Persian/Arab rivalries. The key info for the reader is that the Iranian people are mostly Shi'ite and Persian.
In the final subsection of chapter two, "Ancient Roots", the author discusses the history of the Persian Empire and its transformation into the modern Iranian State.
In her book's timeline Dr. Fry-Revere has finally arrived in Iran. I look forward to "culture clash" episodes. The LIBERTARIAN BIOETHICS BLOGger is also eager to digest firsthand information about the Iranian kidney compensation system.
The first chapter of Dr. Sigrid Fry-Revere's forthcoming new book The Kidney Sellers is entitled "No Turning Back". The chapter is divided into the following four subsections: "Iran Is the Enemy", "Safe Is a Relative Term", "Reality Check", and "A Painful Truth". In this chapter the author details the preparations she made prior to visiting Iran.
In the "Iran Is the Enemy" subsection of chapter 1 Dr. Fry-Revere mentions the Iranian Hostage Crisis, presents the U.S. State Department travel warnings for Iran, and explains how her team dwindled to two (she and an Iranian-American physician) prior to her trip. A reference to the American State-backed coup of the Iranian Prime Minister in 1953 would have been useful for context. The decision, apparently based on fear, of a documentary filmmaker not to accompany the author on the trip was also disconcerting, at least to my previously generally favorable view of documentary filmmakers.
In the "Safe Is a Relative Term" subsection of chapter 1 the author discusses her fear of being kidnapped by cab in Iran, her fortunate meeting with an Iranian nephrologist visiting the United States prior to her trip, and her decision to not request Iranian State permission to perform her research and film her subjects. Her fear about the potential life-threatening risks of the trip is nicely conveyed. Her COURAGEOUS plan to not seek State permission to investigate the kidney donor compensation system while in Iran is my favorite part of this section.
In the "Reality Check" subsection of the first chapter the author relates a disturbing incident at her going-away party, more somber information about dialysis, and an anecdote about a visit she made to a dialysis center in Michigan. The purpose of this section seems to be to persuade readers that Dr. Fry-Revere is not a black-market kidney-selling monster. She succeeds.
In the final subsection of chapter 1, "A Painful Truth", Dr. Fry-Revere reports a conversation she had with an American dialysis patient after her return from Iran. The good: The discussion allows the author to provide the reader with relevant information about the Iranian kidney-procurement system. The bad: The time shift (a flashforward rather than a flashback) was jarring to the LIBERTARIAN BIOETHICS BLOGger.
The introduction to Dr. Sigrid Fry-Revere's forthcoming new book is entitled "A Critical Need". It is subdivided into the following four sections: "From Innovation to Crisis"; "Congress Demands, "Just Try Harder""; "What Next?"; and "Americans Suffer". This book section succinctly introduces the reader to the American State-mandated kidney shortage, the consequence of which will be the premature death of hundreds of thousands of U.S. dialysis patients unless the State allows alternatives to the current system.
The "From Innovation to Crisis" section of the introduction provides a historical account of U.S. kidney transplants (no kidney transplants to identical twin living donor kidney transplants to cadaver/unrelated living donor kidney transplants). Dr. Barry Jacobs's State-funded compensated kidney donation scheme is then described and, appropriately, skewered. The author also reports the sobering fact, unknown to most laypersons and ignored by most physicians, that "the average lifespan on dialysis in the United States is only four years."
The "Congress Demands, "Just Try Harder"" section of the introduction explains the origin of the 1984 National Organ Transplant Act (NOTA), which banned compensated organ donation in the United States. The author then details the extent of the current, and inevitable, black market in kidney sales that was a direct consequence of NOTA and multiple additional States banning compensated organ donation. The author's diplomatic treatment of NOTA, stating "what Congress did seemed reasonable," annoyed the radical sensibilities of the LIBERTARIAN BIOETHICS BLOGger but, given the book's target audience, is understandable.
The "What Next?" section of the introduction notes that, since cadaver kidney organ donation cannot possibly meet U.S. demand, compensated kidney donation "has recently reemerged as a possible solution." A historical account of the successful compensated kidney organ donation system in Iran is then given. Readers are then provided additional horrific statistical data proving the failure of the current U.S. non-compensated system.
The "Americans Suffer" section of the introduction interjects a human-interest story into the narrative, depicting the disturbing life of a dialysis patient (a friend of one of the author's friends).
Dr. Fry-Revere closes the introduction by asserting that she considered donating a kidney to the friend of the friend mentioned in the "Americans Suffer" section. Compassion for the plight of the unfortunate is the fundamental emotional trait of the libertarian. The author, clearly a libertarian, has earned my respect; I shall read on.
LIBERTARIAN BIOETHICS BLOG
Don Stacy is a 43 yo libertarian writer and physician and bioethics graduate student. His articles have been published by multiple libertarian-themed websites. He practices medicine as a radiation oncologist in Louisville, KY and Jeffersonville, IN.