The Kidney Sellers: A Journey of Discovery in Iran

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Rarely does an adventure story carry such social significance as in this groundbreaking ethnographic research book. Dr. Fry-Revere's exploration of the medical ethics of compensating organ donors takes us deep inside Iranian culture to provide insight and understanding into how Iran has solved its kidney shortage. The Kidney Sellers: A Journey of Discovery in Iran addresses the question: How it is possible that in Iran there is a waiting list to be a donor, while in the United States hundreds of thousands of ...

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Rarely does an adventure story carry such social significance as in this groundbreaking ethnographic research book. Dr. Fry-Revere's exploration of the medical ethics of compensating organ donors takes us deep inside Iranian culture to provide insight and understanding into how Iran has solved its kidney shortage. The Kidney Sellers: A Journey of Discovery in Iran addresses the question: How it is possible that in Iran there is a waiting list to be a donor, while in the United States hundreds of thousands of people have died for lack of a kidney? Dr. Fry-Revere is the first Westerner ever to witness firsthand Iran's organ procurement system. She shares what she discovered in this fascinating book: part diary of living in a dangerous country, part ethnographic essay, and part tale of people working together to overcome death and financial ruin. The Kidney Sellers is a shocking, thought-provoking true story.

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Editorial Reviews

Kirkus Reviews
Fry-Revere (The Accountability of Bioethics Committees and Consultants, 1993), the founder of a nonprofit bioethics think tank, goes to Iran to study the effects of legalizing compensation for organ donors. Many Westerners may be shocked to learn that, as untold thousands of Americans die while waiting to receive donated organs, Iran has so many people who want to sell their kidneys that they must get on a waiting list. Fry-Revere, the founder of the U.S.-based Center for Ethical Solutions, writes that "the United States is struggling with a problem Iran seems to have solved." Her book aims to provide readers with "insights into the ethical complexities of living organ donation." The book is partly a scholarly study of organ donation, partly a humorous personal history, and partly a poignant, in-depth look at Iran, following the author as she recounts her trip there and the emotional transformation she underwent. The author has impressive academic credentials, including teaching bioethics and law at the University of Virginia and George Mason University, but she's also passionately connected to this book's issue, which has affected her personally; her son lost a kidney to cancer at a young age. Her narration proves more than capable, as her intelligence and intriguing ethical sense bring her sentences to life. She also adds personal touches; in one paragraph, she describes U.S. State Department travel warnings regarding Iran, and in the next, she relates a nightmare she had, caused by these warnings. Throughout the book, however, kidney donation remains the central focus. She interviews Iranians who sold their kidneys so they could help their families while saving a life at the same time. The issue of economic injustice soon comes into play; Fry-Revere says that some people balk at the idea of selling human organs, believing that "the United States and other countries took a stand against exploiting the poor." Her subject matter may be somewhat controversial, but her analysis is undeniably worth reading. A compelling case for an unorthodox solution to a widespread health care problem.
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Product Details

  • ISBN-13: 9781611635126
  • Publisher: Carolina Academic Press
  • Publication date: 3/17/2014
  • Pages: 254
  • Sales rank: 407,168
  • Product dimensions: 6.30 (w) x 9.30 (h) x 0.90 (d)

Meet the Author

Sigrid Fry-Revere, J.D., Ph.D., is the founder and president of the Center for Ethical Solutions, and is a member of the Washington D.C. Regional Transplant Community's Organ And Tissue Advisory Committee.

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Customer Reviews

Average Rating 5
( 3 )
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Sort by: Showing all of 3 Customer Reviews
  • Posted July 28, 2014

    An Eye Opener ¿ A review of the book ¿The Kidney Sellers: A Jour

    An Eye Opener – A review of the book ‘The Kidney Sellers: A Journey of Discovery in Iran’

    “If any civilization is to survive, it is the morality of altruism that men have to reject” – Ayn Rand

    People who dream to see a better future, not just for themselves, but for everyone in their community work tirelessly to do the right thing in life. Changing the world always starts with a small and a simple act, usually done on a daily basis. The step by step process involves changing our habits, beliefs, and roles we have within our society, and by also becoming conscious of the consequences of our everyday action. This must also lead to understanding emotions better, not just of our own but also of the people around us. Passionate people with big hearts and an even bigger vision for the little home we all call planet earth often undertake such personal journeys that change the course of the fate of all mankind.

    Dr Sigrid Fry-Revere’s nonfiction book ‘The Kidney Sellers: A Journey of Discovery in Iran’ is a systematic study of people and culture told within the backdrop of the kidney donor shortage in the U.S to a seemingly trouble free Iran in the same regard. Set in the format of a quasi adventure story and part documentary style, this research rich book primarily focuses on Iran and the Iranian medical culture that seems to have overcome the problem of kidney shortage for transplants through compensated organ donation. The Kidney Sellers is an exploration into the underbelly of it all, where the author looks at the ethics of compensating for organ donation; from exploitation to the numerous number of lives it has managed to save. Sigrid Fry-Revere tries to find answer to the question why patients are dying in U.S for a lack of kidneys while there is actually a waiting list of people willing to donate in Iran.

    This scholarly work began as a quest to find solutions to the U.S. organ shortage, as there are over 100,000 Americans who need organ transplants at any given time. When Dr. Sigrid learns that Iran is supposed to have a waiting list of donors, she flies out there to research the ethics and even functionality of compensated kidney transplants. She finds out that there are some strict guidelines laid out when it comes to organ transplant in Iran plus a combination of recipient monetary donation and government help which ensures that the donor gets the best medical treatment post surgery. All this has contributed to Iran solving the kidney shortage problem to almost a full extent. Comparatively in America the congressional law preventing compensated kidney transfers and a preference to cadaver organ donation to live donation has all contributed to a pitiable condition for the patients who suffer waiting for the kidney, as the demand keeps outrunning the supply of cadaver kidneys. It has also given way to a parallel black market for kidneys, but this has often ended up exploiting the patients than helping them. Sigrid through her work wants to tell people that a good idea is a good idea no matter where it originated from and sometimes overcoming hasty emotional responses or predisposed judgement calls is necessary to see the bigger and possibly the brighter picture.

    Early on in an understated but pivotal moment in the book the author describes meeting Steve, a friend of a friend currently on dialysis and also on the waiting list for kidney transplant. Description of the author’s meeting with Steve presents itself as the perfect start to the rest of the book. It grabs hold of you by the cuff of your collar and shocks you into attention with the absolute reality of the human element in the entire issue. Sigrid Fry-Revere comes across as very worldly wise, perhaps due to all the travel to different parts of the world and being introduced to different cultures as a child and also perhaps because of the early start to discussions on ethics with her parents, all of which seem to have helped her prepare better and undertake this journey which has been nothing short of an epic one in its preparation, build up and execution.

    It’s not often you pick up a book that doesn’t have a detective, a vampire or pretty young things as its ‘heroes’ and yet compels you to read it cover to cover in one sitting. There are a large number of human interest stories that reveal themselves in light of the interviews that Sigrid conducts, which are both staggering and heart warming at the same time. Sigrid’s Iranian adventure has this very subtle undercurrent of humour element to it, especially in the beginning when she’s acclimatizing to the foreign environment, which is very original and helps in establishing this instant connection to the author’s pursuits.

    A couple of subtle gems that you will in this book are the chapter numbers which are also shown in Farsi numerals and the use of image of a lotus flower as a typographic symbol for section breaks all somehow lead more authenticity and helps establish the mood, since most of the book does deal with Iran. It would be tough for anyone with a mature and functioning conscience reading the book not to feel the gravity of the situation and feel this compelling urge to do something, a positive step in the right direction, to contribute to solving this crisis.

    Highly recommended.

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  • Anonymous

    Posted April 17, 2014

    What a remarkably easy and fascinating read. The title and subje

    What a remarkably easy and fascinating read. The title and subject matter gives the impression this might be a hard to read book on policy, but it is one of those rare books that show the issue for what it is rather than simply analyzes the issues.  Several times I wanted to reach out and shake the closest politician or government health policy maker I could find.  Sometimes the answer to some of our most difficult questions -- like how to solve the kidney shortage--- come from the most unexpected places. You will enjoy Sigrid's journey through Iran, the issues, and her musings about  the proper role of government in helping people help each other.

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  • Posted March 31, 2014

    more from this reviewer

    According to Sigrid Fry-Revere, ethics consultant for the Washin

    According to Sigrid Fry-Revere, ethics consultant for the Washington Regional Transplant Community’s Organ and Tissue Advisory Committee, there were more than 100,000 people on the waiting list for a kidney transplant in the United States at the end of 2013 and about 400,000 people on dialysis.
    The sad truth, she says, is that many of them will die because there are not enough cadaver kidneys to meet their needs and those on dialysis usually only survive for approximately four years.

    “Every year only about 15% of those on the active waiting list get transplants,” she writes. “Most will die waiting. Another 7–8% die or drop off the list (because they are too sick for an operation) without getting a kidney. This translates to approximately 20-25 American dialysis patients dying needlessly every day.”

    Why is this happening in such a progressive country? Fry-Revere says it is because Congress passed the National Organ Transplant Act (NOTA) in 1984 that prohibited anyone from paying for organs. On top of that, doing so could result in a fine of $50,000 and up to five years in jail.
    Based on the ethics that body organs should not be up for sale, this system is why those wealthy enough sometimes turn to purchasing a kidney on the black market. Fry-Revere notes “ a thousand or more Americans purchase illegal organs (mostly abroad) every year.” However, the black market is totally unregulated leaving patients open to contracting such diseases as “HIV, hepatitis and even cancer from improperly screened donors.” And she adds, “Donors are lied to, cheated, and left without sufficient post-operative care.”
    The wealthy can also afford to get an operation as well as take the needed time off work. Thus the poorer folks are the ones more likely to die. Fry-Revere, who is also project director of the Center for Ethical Solution’s SOS (Solving the Organ Shortage) project, views this situation as unacceptable, especially when she learns that a much smaller country - Iran – has solved the problem of kidney shortages. 

    “The United States should be ashamed to be outdone by a country like Iran,” she notes.

    Fry-Revere spent two months in Iran interviewing physicians, nurses, kidney sellers and patients, as well as administrators of non-governmental, non- profits called Anjomans that arrange kidney sales in that country. She became the first person ever to document interviews on film and what she learned about the Iranian’s legal compensation system has proved invaluable.

    One cannot read this book without feeling deep sympathy for not just the kidney patients who die each year in the U.S. but also for the families who are forced to watch them slowly dwindle away on dialysis. For Fry-Revere it also strikes close to home because her own son was diagnosed with kidney cancer when he was just 10 months old. 
    For this writer living in Canada brings the same restrictions as the U.S. I could only helplessly watch as a good friend and former co-worker on dialysis slide toward death’s door. According to Organ Donation and Transplantation in Canada, kidney donations have not increased over the past 10 years and ironically it is believed that copying the U.S. would provide the solution.

    This book is a work of creative non-fiction. As such Fry-Revere, who is also president of Stop Organ Trafficking Now, uses not just her own knowledge of the situation but also relates the stories of others both in the U.S. and Iran in a way that is informative, interesting, easily readable and most importantly, heartfelt. Travel along with this courageous woman, who took her chances filming interviews without government permission. Find out why the 25-year-old Iranian system works and what problems still exist. Learn how donors are compensated and kidney patients are helped. Also discover how administrators, donors and patients deal with the ethical problems that have caused the U.S. to refuse to institute a similar system. Most importantly, learn what life on dialysis is really like. It will surely break your heart.

    Aside from compelling personal stories, Fry-Revere also gives us a glimpse of life in current-day Iran that is far different than what the media and the U.S. government have led us to believe. This book is definitely worth five stars and a must-read that is hard to put down.

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