Thursday, March 13, 2014

Sigrid Fry-Revere

The Kidney Sellers
A Journey of Discovery in Iran
By Sigrid Fry-Revere
A book review by Ginger Dawn Harman

Dr. Fry-Revere’s brand-new ethnographic research book, The Kidney Sellers: A Journey of Discovery in Iran addresses exploration of the medical ethics of compensating organ donors and that takes the reader deep inside Iranian culture, providing insight into and understanding of how Iran has solved its kidney shortage crisis. This powerfully argued new research book makes clear that the wider the gap between ethics and medical technology becomes, the harder it is for a government and ethnopsychologist to bridge it: put simply, what is good for one side is bad for the other. It is also clear that the need for serious action has never been greater for those who suffer from kidney disease. An estimated 26 million adults, or one in nine Americans, have chronic kidney disease, and another 20 million are estimated as being at risk of developing the disease. Dr. Fry-Revere’s years of research have led her to investigate, 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? Putting her own personal safety at risk, without knowledge or consent from the Iranian government, the author traveled the country and interviewed kidney donors, recipients, Iranian transplant staff, medical transplant physicians, and Anjonman staff, who provided much information on the historical to current practices in Iran. With nine binders of just video transcripts alone, Dr. Fry-Revere and Dr. Bahar Bastani have documented the raw and honest data affording possibilities for answers to the American kidney crisis.

Published by Carolina Academic Press

When I was first approached through my website to review this non-fiction, I thought why choose me? I am not a medical or law expert. I am now thankful for the opportunity because this book has taught me a great deal. In today’s society, many have become accustomed to, “if it doesn’t affect me then it is not my problem.” It is our problem. With the alarming data of black market of kidney sellers who abduct, and exploit, everyone has either an acceptability to respond or to turn one’s head. Unfortunately, it is not until something becomes out of control that policies are rushed and passed into law. This is not only dangerous but creates a desperate quick fix. The Iranian government has a legal system that is working and which could be used as a model for the kidney organ crisis that we face in America. At heart, this is a book about finding solutions and maintaining ethics.

Dr. Fry-Revere’s, The Kidney Sellers: A Journey of Discovery in Iran, is a thought provoking, well researched, and educates the reader to the importance of the kidney shortage crisis. The author shares in it personal stories of her childhood abroad and her time at the University of Geneva. As a young woman, she was given a foundation of global ethics by wide-ranging discussions with her parents, and her own experiences with street urchins in Naples, and such things as the suffering of lepers, and death met in the form of a dead body discovered in Rio de Janerio. This personal honesty sets a minor theme to the book as to what is more important. A person’s life and well-being and what is the monetary value of a life. Many of the stories are moving enough to raise tears, “Steve’s Story” provides psychological insight to waiting for a kidney in America.

In contrast, a mother in Iran, sells her kidney in order to pay for her daughter to attend university, and a young man sells his kidney to pay his Diyya. In addition, the book provides several examples of the negative stereotypes and labels one receives in America and Iran when donating/selling a kidney. It was also interesting to read the difference Dr. Fry-Revere and Dr. Bahar Bastani had in cities such as Kermanshah, Shiraz, Isfahan, and Tehran.

The Nasir al-Mulk Mosque, Shiraz, Iran
The kidney shortage can be solved. This has been proven in Iran. Some may find the Iranian approach disagreeable. Moreover, the Iranian legalized compensation program for kidney donation is not without flaws. The United States does have a kidney donation system through altruistic means. Yet, most that receive a kidney are well-to-do, leisure class, and upper middle class. It is important to note that most expenses for the donor are not covered by medical insurance. Meanwhile, the poor, average working class, and unemployed have to watch their family and friends die on dialysis or wait for a second class cadaver kidney that statistically has a very low chance of coming.

Ms. Shahnaz Abdulwahaz, Afghan dialysis patient. In Iran, only Iranian citizens can get transplants at government expense. More photos at this link
The price of this book is appropriate and the front cover is intriguing. It has a simple eye-catching design that evokes a powerful message. The choice of the Iranian flag and red lettering conveys energy, passion and action. The reading audience or level of experience that is needed to use the information in this book would be ages 25 and older. Physicians, political law makers, researchers, medical students, and those looking to understand the kidney shortage issues will benefit most from this work. I have not been able to locate any existing book that covers this type of research on the market. The Kidney Sellers: A Journey of Discovery in Iran does not use stilted language; it is very readable as well as technically accurate. The author takes great care to explain the religious and cultural difference in Iran to help the reader understand the background.

Sigrid Fry-Revere, J.D., Ph.D., is the founder and president of the Center for Ethical Solutions, a non-partisan, non-profit, public charity dedicated to educating the public on issues in patient care ethics. Dr. Revere has more than a hundred articles published in newspapers, journals, and trade publications such as The New York Times, The Los Angeles Times, The Wall Street Journal, The Cambridge Quarterly of Healthcare Ethics, The Journal of Clinical Ethics, and Pediatric Nursing. Sigrid is also the medical ethics consultant to the Washington D.C. Regional Transplant Community's Organ and Tissue Advisory Committee. I highly recommend The Kidney Sellers: A Journey of Discovery in Iran by Sigrid Fry-Revere.


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