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Would you give your kidney to a stranger?

The ethics and hazards surrounding living donors

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Barry Mendez is comforted by a friend after his surgery.

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BALTIMORE, Maryland (CNN) -- Barry Mendez gave one of his kidneys to a stranger -- a good-natured act that has stirred concern among medical ethicists.

It is not unusual for doctors to get organs from corpses or from people who know the recipient. In 2005, for example, about 6,900 transplants involved living donors, nearly all of whom were relatives or friends of the recipient.

By contrast, Mendez is one of only about 400 people nationwide who are known to have ever donated to a stranger.

Mendez is a member of the Jesus Christians, a group that calls itself a "live-by-faith, work-for-God-not-money Christian community." There are 28 Jesus Christians worldwide and 15 have given kidneys. (Watch donating for salvation -- 2:26)

In Australia, where the group was founded, the government for the state of Victoria is suspicious of the Jesus Christians and has banned its members from donating to strangers.

The Australian press has alleged that leader David McKay has coerced members into donating. McKay says the Jesus Christians are not a cult and he has never coerced any of them into donating a kidney.

Mendez said he gave his kidney willingly.

"I have done something to help someone," Mendez told CNN after his surgery last year at Johns Hopkins Hospital in Baltimore. "And that is the message of love basically, from my understanding, what Jesus was trying to teach us."

Many European countries ban so-called good Samaritan donors or make it difficult for them to donate. As a result, some like the Jesus Christians come to the United States.

Disagreement on the issue

Psychiatrists, surgeons and ethicists are split on the issue of whether people should donate organs to strangers. (Listen to arguments on both sides)

While Johns Hopkins and other prestigious transplant centers like the Mayo Clinic in Rochester, Minnesota, have taken organs from Jesus Christians, others think the practice is patently wrong.

Donna Luebke, a practicing nurse and board member of the United Network for Organ Sharing, which oversees transplantation in the United States, said she cannot believe hospitals take organs from Jesus Christians.

"I think their leader's coercive of the followers," Luebke said. "I think there needs to be an investigation into what centers are doing those surgeries."

Art Caplan, a bioethicist at the University of Pennsylvania, said hospitals have other concerns.

"They're not thinking about the donors first and foremost. They're thinking about the recipients," Caplan said.

"They're thinking about what that means to save lives, which is why they do this. What it means to keep them financially going, which is done by transplanting people.

"You're out of business if you don't have the organs," Caplan continued. "And that's the first and the second order of business. Kind of down at third or fourth [are] donor advocacy, donor protection."

Mendez's surgeon at Johns Hopkins, Dr. Robert Montgomery, said Mendez was given a psychological examination and found to be fit.

"Just because a large number of people in a group have done a good thing doesn't mean they're crazy," Montgomery said.

Physical requirements

Aside from these psychological and ethical issues, experts can't agree on physical requirements.

If someone has high blood pressure, should they be allowed to give a kidney? What if high blood pressure damages the person's remaining kidney years later?

If someone is grossly overweight, should doctors let them give a kidney, even though obese people have relatively high rates of kidney problems later in life? What kind of risk is acceptable?

"Why not?" said Dr. Benedict Cosimi, president of the American Society of Transplant Surgeons. "An individual may have what, by written guidelines, is alcoholism, but is a functional individual and can make a decision and wants to give an organ to a family member or a loved one.

"And I think they should be allowed to do that. And the same thing is true with individuals who have drug issues."

Cosimi said if there were more rules to living donation, fewer people would donate.

CNN found transplant surgeons have different ideas about risk. In many ways, it comes down to whether having a kidney or a liver section removed affects a person's health years later.

But hospitals don't routinely follow living donors for more than a year -- if that long.

A prominent transplant doctor told CNN, "Well, we don't track people for years after having bunion surgery, either."

The United Network for Organ Sharing says there have been more than 75,000 kidneys tranplanted from living donors since 1988. A study by the group found that 117 kidney donors have ended up years later on the waiting list themselves looking for kidneys.

Psychological hazards

There also is some indication that some people have adverse psychological effects after donating an organ.

A University of Pennsylvania study found that some donors become depressed, even suicidal, after donation.

One of the study's chief researchers, Dr. Robert Weinrieb, said people who want to donate to strangers, for nothing in return, make him particularly nervous.

"What makes me uneasy is the possibility that these people are trying to fix something in themselves," Weinrieb said.

"And they may be very disappointed once they've done that and found that the thing they've tried to fix can't be fixed."

Mendez, in his early 30s, has pronounced himself healthy, psychologically and physically well -- more than a year after his kidney donation.

He now travels through Europe doing missionary work.

"CNN Presents" teamed up with Deborah Shelton of the St. Louis Post-Dispatchexternal link and the Center for Investigative Reportingexternal link to produce "Body Parts."

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