Kidney donation: the question of coercion

One of the things that makes selling kidneys repugnant to many is the intuition that, if kidneys could be sold, poor people might feel coerced to sell.

Of course, removing money from the transaction doesn't necessarily remove coercion. When a transplant center evaluates a living donor, one of the things it tries to determine is if the donor is really willing. Families, of course, can exert coercion.  Here's a recent advice column from the Washington Post...Family plays 'please pass the kidney'

"DEAR AMY:

One of my in-laws needs a new kidney. She will be undergoing the transplant process soon. Her family wanted me to give her one of my kidneys. My family said no to this, and so I did not get tested beyond the blood test (we are the same blood group). Now my in-laws are angry and have stopped talking to me.

"I would like to know how my sick relative is doing, but I don’t know what to say when I call, or whether I should call.

"In the past they have said horrible things to me because I did not donate my kidney; it seems now that our long friendship is meaningless.

"I still care for her and her family, but how do I let them know that I am thinking about them? I know if I try to call, the woman who is getting the transplant will say nasty things to me. What should I do? --

Upset"
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Amy's reply seems sensible enough under the circumstances:

"DEAR UPSET: If donating an organ is what it takes to get in good with your in-laws, then their standards are a tad unreasonable.

"I assume there are other dynamics at play which created this pressure on you, but if you are eager to reach this in-law but don’t want to risk the verbal backlash, then the best way to do so is through a greeting card.

"When you send a message through the mail, you lessen the opportunity for back talk."
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HT: Dr. Scott Kominers