When Giving Cuts Right to the Bone

Years ago, when I was doing a Masters of Bioethics under renowned philosopher Peter Singer at Monash University in Melbourne, I signed up to the newly founded Australian Bone Marrow Donor Registry.

The donation of bone marrow is not a simple or pain-free procedure, but I was young and single and surrounded by people absorbed with doing the right thing. At the time I was vegetarian and caring for a young man dying of HIV/AIDS. Offering a gift of life to someone with leukaemia or other fatal blood disorders without so much as a backwards glance was what I wanted to be – and thought I was – all about.

Fast forward a few years and I had become a mother, teething baby in one arm and a toddler under the other. Undone as much by overwork and lack of sleep as by the guilt of the working mother enterprise (these were the Howard years, remember?), the call came one afternoon. It was from the registry. A woman in another state in Australia was sick and needed a bone marrow transplant, but none of her siblings was a tissue match. Initial tests of my blood suggested I might be able to help.

Back then – this was before 2001 – there was only one way to get bone marrow (today, this method has been joined by another, which has its own risk profile). I would have to go into hospital and have a general anaesthetic so doctors could extract the required cells from my pelvic bones using hollow needles. Afterwards there would be bruises, pain and stiffness.

I would need pain relief and would have trouble walking (one woman described it like being kicked by a horse). If I was truly unlucky, the rare risks associated with general anaesthesia, transfusion and infection or injury at the needle site might come into play.

I’ll be perfectly honest. I did not want to do it. I absolutely did not want to do it. At that point in my life, I needed the risks and complications of tissue donation like a hole in the head.

Normally, when a person accepts the costs of a medical procedure it is because she sees them as favourably offset by its benefits – to her. For live tissue donors the equation is different. Donating bone marrow required me to assume both the certain complications and unknown risks of the procedure to benefit someone else – a person I did not know.

As it turned out, I never had to choose. Additional tests revealed I was not compatible and so the registry’s search for a donor moved on. Or so I presumed. For privacy and practical reasons, I could never find out what happened to the woman and whether a tissue-matched donor was ever found.

So what if someone from the Australian Bone Marrow Donor Registry rang me today?

They might because, despite the anguish and uncertainty I suffered so many years back, I ultimately decided not to take my name off the database.

This was not just because I knew my kids would likely be older and less dependent when the phone rang again, but because, however inconvenient and unpleasant it might be, giving marrow to a stranger is the right thing to do.

Indeed, it is the absence of the usual emotional pulls to gift-giving – love, friendship, social obligation – that make live, anonymous tissue donation proof positive that altruism exists. And altruism is the beating heart of morality.

So get on the registry. Give the gift of life.

Publication history

When Giving Cuts Right to the Bone  The Sun-Herald (Sydney)