After a 2004 kidney failure, 60-year-old Denver lawyer Steve Farber received a kidney from his 32-year-old son; down the hall on the same day, Sandra Delaroca, a 19-year-old Guatemalan immigrant and fast-food worker, received a kidney from her brother. In On the List (Rodale), Farber, along with former legal partner and professor Harlan Abrahams, chronicles wealthy versus working-class transplant journeys. Together, Farber and Delaroca’s stories frame the legal, ethical, and emotional implications of considering every option but death.

5280: You could have told a very compelling tale without including the Delarocas’ story. What purpose did that serve?

5280 November 2009
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Steve Farber: It gave us contrast to my story—a perception of someone who had access and wealth, and someone who didn’t. At the end of the day, here we were, both looking to family to solve our issues.

Harlan Abrahams: The poor tend to deal with life-threatening issues in a very different way than the rich: less hand-wringing, more acceptance. Ernesto and Sandra could never have even contemplated going abroad to buy a kidney. For them, the gift of life came from working entirely within the system. They had no other choice.

5280: What about the alternatives?

SF: I had other options, but not clarity. I said, “I’m not going on dialysis.” I thought I could eat healthy, work out, and survive. I really did. You paint a pretty picture. You’re dealing with your own illness, which clouds your thinking. It is a maze.

HA: Going through the maze is an important part. You know that saying, “He who represents himself has a fool for a client”? It’s sort of the same when you’re going through something like this. You really need a medical advocate.

5280: You pondered traveling to Turkey to purchase a kidney.

SF: I sent my medical records [to Dr. Zaki Shapira in Turkey], and I asked, “Is it legal?” He said, “It’s a little bit gray. But don’t tell anyone you’re over here doing it.”

HA: Shapira is a notorious organ outlaw.

SF: I’m kind of a moralistic guy deep down. So I wanted to be at home and deal with the system the right way.

5280: Would you call America’s system fair?

SF: No amount of money and power can get you moved up on the list. The system does have integrity. But there are a lot of inconsistencies. It’s illegal to sell an organ for transplantation; it’s not illegal to sell an organ for research.

5280: In a nutshell, what’s the takeaway?

HA: We do not believe in a free-market system where people buy and sell organs. We do believe in compensated donation, where people get economic incentives like tax benefits. We really are trying to save lives.