Zell Kravinsky is a poster boy for bioethicist Peter Singer’s theories of utilitarian altruism. A real estate magnate, he gave away most of his fortune to health-related charities. Then he settled upon the ultimate donation. After calculating the risks, he donated a kidney to a total stranger, despite protests from his wife. Assuming that he has only a 1 in 4,000 chance of dying as a result of the transplant, not donating meant to him that he would be treating his life as 4,000 times more valuable than a strangers. This made him a highly attractive case for Singer, as he believed strongly in the equal value of all human life, one of Singer’s dogmas.

However an article in the latest Journal of Medical Ethics challenges Kravinsky’s calculations and the optimistic assumption that live donors give at very little risk to their health. "Recent data suggest that the long-term risk in living kidney donation and the personal cost may be higher than previously thought," writes Walter Glannon, of the University of Calgary. Although most discussion of the risks for donors focuses on complications from the surgery itself, they may experience significant problems later in life, especially from diabetes and kidney failure. And in view of the rising incidence of diabetes, Glannon suggests that the risk of donating a kidney might be increasing. His argument has particular relevance nowadays as living donors are being courted by transplant surgeons, hospitals, internet registers and desperate relatives. ~ Journal of Medical Ethics, March