Chapter 19 Dying to Save Lives: Zell Kravinsky, , and Lethal

TADEUSZ LEWANDOWSKI

ABSTRACT: In 2003, after disbursing the bulk of his accumulated fortune of forty-five million dollars to various charities, Zell Kravinsky made the even greater altruistic decision to donate one of his kidneys to a complete stranger. In doing so he incurred the wrath of many in the psychiatric and health professions who questioned his sanity. In response, Kravinsky argued that refusal to donate would have constituted a violation of his belief in “maximum human utility” – a philosophical concept that insists we give up as much as we can for the good of others. Kravinsky has since stated that he would undergo a lethal organ donation in order to save a greater number of people from death, or to save people who might better serve humanity. He has even gone so far as to suggest he would sacrifice the lives of his children to save a greater number of others. Only one prominent utilitarian philosopher, Peter Singer, has come to Kravinsky’s defense suggesting that maximum human utility’s moral principles are entirely sound. This paper examines utilitarian valuations of the com- mon good through the principles that underpin Kravinsky’s beliefs. KEY WORDS: Zell Kravinsky, Peter Singer, maximum human utility, utilitarianism, lethal organ donation

1. Introduction

On July 22, 2003, American investor, professor, and philanthropist Zell Kavinsky saved a life. In ’s Albert Einstein Medical Center, surgeons removed his left kidney and transplanted it into a dying woman Kravinsky had met only once. This was not the first time that Kravinsky had attempted to help others. Over the previous year, he had donated almost his entire fortune of forty-five million dollars to charities, hospitals, and health centers. In giving away a part of himself, Kravinsky merely wanted to further express his philosophical convictions. This philosophy was one of his own making. Termed “maximum human

Pobrano z https://repo.uni.opole.pl / Downloaded from Repository of Opole University 2021-09-28 242 TADEUSZ LEWANDOWSKI utility,” it demanded that he, and all humans, do as much as they can to relieve the suffering of others. But this was not all. Soon after his kidney donation, Kravinsky stated that he would give up his life by undergoing a lethal organ donation. This course of action was justifiable, he stated, merely by the simple utilitarian fact that it would save a greater number of lives, and thereby enhance the common good. Many academics and other professionals, from philosophers and psychologists to medical doctors, were quick to question not only Kravinsky’s philosophy, but his sanity. Only one utilitarian philosopher, the Australian Peter Singer, came to Kravinsky’s defense. Whether there is any basis for a defense of Kravinsky’s principles in terms of their efficacy in promoting the common good, however, remains questionable. More likely, his philosophy and its sanction of lethal organ donation lead over a moral precipice.

2. Zell Kravinsky and the donation

Kravinsky was born in 1956 in Philadelphia, Pennsylvania, to Russian Jewish immigrants. He and his family, which included two sisters, faced constant poverty. This lack of financial support was coupled with a lack of parental support for the family’s children. Kravinsky’s father, Irving, was a committed socialist who believed deeply in the promise of the Soviet Union, but less so in the promise of his only son. As a result, during his formative years any paternal praise Kravinsky might have garnered was siphoned off into revolutionary rhetoric and injunctions to stay true working-class concerns. Even when Kravinsky, an unusually bright young boy, was named best student at his elementary school graduation, his father could only comment: “Well, next year you’ll be nothing.” Fully imbibing his father’s proletarian concerns, young Kravinsky took to reading Gandhi and at age twelve demonstrated before Philadelphia City Hall in an effort to lobby for low-cost public housing. Though this bout of activism remains one of the very few instances when he gained his father’s approval, Kravinsky’s academic successes continued unabated, earning him a scholarship to Dartmouth in 1971. After graduation, Kravinsky re-settled in Philadelphia. There, he began dealing in the rental market and real estate surrounding the University of Pennsylvania’s campus. Seeking to balance his capitalistic urges with moral idealism, Kravinsky took a job at an inner-city school, which fed his desire for self-sacrifice and moral edification. Real estate proved considerably more lucrative. Kravinsky understood both math and money, and by the early 1980s he had purchased several

Pobrano z https://repo.uni.opole.pl / Downloaded from Repository of Opole University 2021-09-28 Dying to Save Lives... 243 properties, including a three-story apartment building. Though he was earning a great deal of money, he did not indulge himself. Instead, Kravinsky inhabited one windowless room that did not even include a shower or kitchen. He spent his free time planning investments (Parker 2004). A turning point came in 1984 when Kravinsky’s beloved sister, Adria, died from lung cancer at age thirty-three. The unfortunate event plunged Kravinsky into a long and severe depression. The only thing that enabled him to survive “was the thought [he] would do good in her name” (Fagone 2003). Kravinsky quit his job as a teacher after a student lured him into a brutal mugging, and returned to school to earn two doctorates in composition theory and Renaissance literature from University of Pennsylvania. While studying, Kravinsky met his future wife, a psychologist. Their family soon grew to four children, and Kravinsky abandoned his academic career in favor of real estate. Armed with his rhetorical powers and successes as a landlord, in the 1990s Kravinsky took out a loan for two million dollars. Almost effortlessly, within five years Kravinsky managed to acquire a forty-five million dollar property portfolio that boasted shopping malls and warehouses. Nevertheless, his family benefited little. The Kravinskys occupied a typical suburban home, drove an old Toyota van, and wore second-hand clothes. Kravinsky clearly had aptitude for getting rich, but not being rich. He soon convinced his wife, who had tired of the stress of carrying multimillion-dollar loans, that creating a public health foundation in his sister Adria’s name and giving donations to various charities, such as the Centers for Disease Control and Prevention, would be good in itself. Kravinsky also argued that abandoning the real estate business would bring him closer to his family. After setting up modest trust funds for his children and other relatives, by 2003 Kravinsky had given away everything save eighty thousand dollars, and the family home and cars (Parker 2004). But this was not enough. Around the time Kravinsky was relieving himself of the last of his oppressive possessions, he read an article in the Wall Street Journal on the subject of non-directed kidney donation. It informed him that over three thousand five hundred Americans die for need of a transplant every year, while over three hundred thousand must suffer through dialysis – a grueling six-hour process that must be performed three times a week (Fagone 2003). Kravinsky also learned that the risk of dying for the donor was one in four thousand, and the vast majority of donors experienced no ill effects as a consequence of living with one kidney. After concluding that there was only the smallest of chances his children would be stricken with kidney disease and require a transplant,

Pobrano z https://repo.uni.opole.pl / Downloaded from Repository of Opole University 2021-09-28 244 TADEUSZ LEWANDOWSKI and factoring in that he had only about ten years left as a viable donor, Kravinsky decided to give away a kidney as “a treat to myself” (Schwartz 2003). His family and friends, however, were unenthusiastic – despite his arguments about the procedure’s low risk and the clear “good” the donation would do by “the mathematical calculus of utilitarianism” (Parker 2004). Deeming the wishes of those closest to him “greed and selfishness” and ignoring any fear of potential risk, Kravinsky walked into Philadelphia’s Albert Einstein Medical Center and announced that he would like to make a non-directed kidney donation (Majors 2003). The transplant coordinator was suspicious, as was the surgeon who interviewed him. Following a psychological evaluation in which Kravinsky admitted to bouts of depression and the fact that his wife did not approve or even know of his plans, after several months the hospital finally relented on the basis that Kravinsky was mentally competent and had a legal right to do as he wished. For his part, Kravinsky’s condition was that his kidney be transplanted into a poor African American (Majors 2003). A woman named Donnell Ried was selected from the waiting list and Kravinsky met with her for two hours, during which they discussed her plans for the future. She had suffered on dialysis for eight years and would have died without a transplant. Surgeons successfully performed the procedure two weeks later. Attending was a local reporter, who Kravinsky had invited in the hope that the story would encourage others to donate. Kravinsky nonetheless kept all this from his wife, who learned of the transplant from the morning paper and immediately threatened divorce (Parker 2004).

3. Maximum human utility and its detractors

It was not only Kravinsky’s wife who objected to his actions. Numerous voices within the media condemned him for harboring secret guilt or being just plain crazy (Lane 2003). Some even labeled him a “heartless lunatic” in search of “self-glorification” (Schwartz 2003). Kravinsky did not shy away from such criticisms. His initial statements on his financial gifts displayed an irrefutable rationality in the spirit of a simple, pure moral imperative. He explained to the press that charity was a much better use of his money than “a bunch of high-tech toys that I’m not really interested in” (Majors 2003), adding perfunctorily that with regard to giving: “If you can do more, and you’re not doing it, why not? (Schwartz 2003). Specifically concerning his kidney donation, Kravinsky argued that his risk was minimal, while Ms. Ried would have certainly died without his donation. To value his life more was “obscene

Pobrano z https://repo.uni.opole.pl / Downloaded from Repository of Opole University 2021-09-28 Dying to Save Lives... 245 and unacceptable” (Zahn 2003). In fact, Kravinsky appeared entirely confused at the condemnation he had inspired, insisting that: “I’m not generous, and I’m not insane. Maybe the sanest thing I do is give things away” (Schwartz 2003). Over the following months Kravinsky began to propound his philosophy of giving, which he termed “maximum human utility.” Its basis was that we are all “morally and logically” obliged to give all we can to ameliorate the circumstances of others, and especially, to save lives (Zahn 2003). Anyone refusing to do so is “responsible for [another’s] death” – or to put it differently, a murderer (Laurence 2004). It was not long until Kravinsky took this belief to its logical conclusion. In an interview for the cable news network, CNN, he suggested that he would sacrifice his live through a lethal organ donation to save others who could potentially produce more good in the world than he (Zahn 2003). This was a principle that Kravinsky applied not only to himself. When asked “to calculate the ratio between his love for his children and his love for unknown children,” Kravinsky responded: “I don’t know where I’d set it, but I would not let many children die so my kids could live. I don’t think that two kids should die so that one of my kids has comfort, and I don’t know that two children should die so that one of my kids live” (Parker 2004). Kravinsky has since openly fantasized about donating further body parts, whether a lobe of his lung, part of his liver, or his remaining kidney (Schwartz 2003). The notoriety Kravinsky gained from his press interviews and television appearances quickly drew the attention of a spectrum of professionals and academics, from philosophers and psychologists to medical doctors. All of them had differing answers for his behavior; all were heavily critical of his thinking and actions. Outrage greeted Kravinsky’s statements on the lives of his children. Philosophy Professor Judith Jarvis Thomson (MIT) commented: “His children are presumably no more valuable to the universe than anybody else’s children are, but the universe doesn’t really care about any children [...] A father who says, ‘I’m no more concerned about my children’s lives than anybody else’s life’ is just flatly a defective parent; he’s deficient in the views parent ought to have, whether it maximizes utility or not” [emphasis in original] (Parker 2004). Any parental failings aside, others posited that Kravinsky was perhaps the victim a pathological benevolence brought on by either painfully low self-esteem, or profound narcissism (Malikow 2011). Professor of Medical Anthropology Nancy Scheper-Hughes argued:

Zell Kravinsky should not be made into a hero for donating one of his kidneys to a sick woman he did not know, and then considering donating his second kidney to another stranger, or even becoming the first total (living) body donor, so that he

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could save even more lives. Sacrificing one human life in exchange for many lives is an impressive moral imperative, except that it is, of course, quite mad. In slowly dismantling himself, Kravinsky would not only be killing himself; he would be (emotionally) murdering his wife and children [...]. Kravinsky’s Franciscan impulse to strip himself bare and rid himself of all his troublesome worldly goods (including his own body-self) speaks, albeit eloquently, to his self-loathing and narcissistic injury. Kravinsky’s search for “ethical euphoria” is similar to that of the teen-age suicide bomber [...]. Pathological generosity, even in the service of humanitarianism, is not something to encourage. Kravinsky needs to find a better way to love mankind than hating himself. (Vischer 2004)

One commentator, meanwhile, sought a more chemical-based expla- nation, noting that Kravinsky’s “overwhelming sense of guilt and responsibility” was possibly “a strong instance of obsessive-compulsive disorder” (Samberg 2005). Regardless of the source of his astonishing munificence, the insane quality it exhibited prompted Professor of Psychiatry Paul Find to stress: “If he does [make a second kidney donation] then there’s something really wrong. And if I were his wife, I’d have him committed” (Malikow 2011).

4. Singer’s support

Though Kravinsky gained many detractors for his remarkable philoso- phical views, his generous acts earned some fans, as well. He has been lauded as a “secular saint” (Bingham 2010). The 1950s pop music icon and Christian evangelical Christian Pat Boone has called him “an American hero” (Schwartz 2003). Shortly after his kidney donation the Pennsylvania House of Representatives even cited Kravinsky as “a shining example of humanity and a beacon of compassion” for his philanthropic work (Schwartz 2003). Yet there is only figure who fully embraces both Kravinsky’s actions and philosophy: Peter Singer, currently teaching at Princeton. As the most famous utilitarian philosopher born in the twentieth century, Singer is a strong ally in Kravinsky’s cause. Singer’s work deals with a wide range of moral issues, from animal rights to euthanasia, infanticide, and abortion. His stances have more often than not courted bitter controversy. Among other things, Singer argues that the lives of humans and dogs have equal value, and performing medical experiments on disabled cataleptic orphans is likely preferable to experimentation on healthy rats. Regarding euthanasia, abortion, and infanticide in cases of mortal illness or severe handicap, Singer has stated that: “The notion that human life is sacred just because it’s human life is medieval” (Specter 1999). When faced with the birth of a hemophiliac, for instance, Singer insists that it is better to kill the child and replace it with a healthy one, thereby increasing the

Pobrano z https://repo.uni.opole.pl / Downloaded from Repository of Opole University 2021-09-28 Dying to Save Lives... 247 general amount of happiness, or common good. Yet at the same time, Singer insists on equal value for (healthy) “persons” (which includes animals) under the umbrella of utilitarian conflation (Specter 1999). The Singer essay that comes closest to Kravinsky’s idea of maximum human utility is “Famine, Affluence, and Morality,” published in 1972 (Parker 2004). In it Singer argues that ignoring requests for charity, for example solicitations in the mail to feed starving children in Bengal, is the ethical equivalent of ignoring a drowning child right before one’s eyes. He writes: “It makes no moral difference whether the person I can help is a neighbor’s child ten yards from me or a Bengali whose name I shall never know, ten thousand miles away.” For that reason, “if it is in our power to prevent something very bad from happening, without thereby sacrificing anything morally significant, we ought, morally, to do it.” In essence, then, not taking action to stop bad things is the same as doing bad things, and as such, people in wealthier nations have a moral obligation to donate to the world’s poor at the expense of their own standard of living and consumer market for unnecessary luxuries. As a basis for this principle, Singer rejects the notion that “we are morally entitled to give greater weight to our own interests and purposes simply because they are our own” – or, one should add, the interests of our families and those close to us. The only way to a moral life, therefore, is to make sacrifices of “comparable moral importance,” meaning in concrete terms “that one would reduce oneself to very near the material circumstances of a Bengali refugee” (Singer 1972, 241-243). In the more recent essay “What Should a Billionaire Give – and What Should You?” Singer continues his arguments regarding the alleviation of third-world poverty and the “ideal of valuing all human life equally” (Singer 2006). Specifically, the philosopher indicates Kravinsky as a moral model:

What marks Kravinsky from the rest of us is that he takes the equal value of all human life as a guide to life, not just as a piece of rhetoric. [...] Kravinsky’s love for his children is, as far as I can tell, as strong as that of a normal parent. [...] But that does not, in Kravinsky’s view, justify our placing a value on the lives of our children that is thousands of times greater than the value we place on the lives of the children of strangers. (Singer 2006)

Singer goes on to praise Kravinsky for the declaration that he would allow his own child to die in order to save two others. And as a reward for promoting utilitarianism, Singer has invited Kravinsky to speak at his classes at Princeton (Shea 2005). But while Singer dubs Kravinksy “a remarkable person who has taken very seriously the questions of what are our moral obligations to assist people,” he admits that Kravinsky’s path is not one easily followed: “I think it’s difficult for

Pobrano z https://repo.uni.opole.pl / Downloaded from Repository of Opole University 2021-09-28 248 TADEUSZ LEWANDOWSKI people to go as far as he has, and I don’t think we should blame people who don’t, but we should admire those who do” (Parker 2004). For Kravinsky’s part, Singer’s commendations stand as a “great honor” that has helped legitimate his beliefs and actions (Laurence 2004).

5. The dangers of maximum human utility

Nonetheless, Singer is often criticized by philosophers who argue that he displays an overwhelmingly impersonal viewpoint whose logical conclusions lead over a moral precipice (Specter 1999). Similar criticisms can easily be applied to Kravinsky’s maximum human utility when examining its basis. Kravinsky’s moral scheme, which ends in lethal organ donation, can be distilled into two principles: 1) we should give up our lives for those more valuable to society than ourselves, and 2) we should give up our lives because our organs can save a greater number of lives. Yet the consequences of putting these beliefs into practice, almost needless to say, could range from harvesting the organs of the mentally and physically handicapped, to erasing the very notion of the individual’s right to his own body (Lewandowski 2014, 49-50). These are arguably dangerous guidelines. When Kravinsky states he would his donate his remaining kidney, for instance, to a dying child, he ignores that under his beliefs system a person should give up their life to those more useful to society, meaning that under purely utilitarian terms children – who require the expenditure of resources to raise and directly contribute little in terms of productive service to humanity – might not qualify. Therefore, in Kravinsky’s philosophy sustaining one’s own life soon becomes immoral. Merely living in a world where others are of want would be categorized as depraved. Hence, the question remains as to whether maximum human utility would promote the common good. The obvious answer can be taken from a critique of Singer’s proposals for sacrifices of “comparable moral importance” in “Famine, Affluence, and Morality.” Professor of Philosophy Colin McGinn (Rutgers), asks: “What if you took every penny you ever had and gave it to the poor of Africa, as he would have us do? What we would have is no economy, no ability to generate new wealth or help anybody” (Specter 1999). Who is to say, then, that that present system (its horrifying inequalities notwithstanding) does not promote greater good in comparison to leveling of all to the penury of Bengali refuge? And indeed Kravinsky, in his willingness to die, goes even further than Singer in his moral prescriptions (Shea 2005). Singer, after all, delineates limits short of death in “Famine, Affluence, and Morality,” arguing that people should give to others only until “the point at which

Pobrano z https://repo.uni.opole.pl / Downloaded from Repository of Opole University 2021-09-28 Dying to Save Lives... 249 by giving more one would begin to cause serious suffering for oneself and one’s dependents – perhaps even beyond this point to the point of marginal utility, at which by giving more one would cause oneself and one’s dependents as much suffering as one would prevent in Bengal” (Singer 1972). Maximum human utility, however, demands the death of those fortunate enough to enjoy better circumstances. Ultimately, then, as glibly pointed out by Philosophy Professor Frank J. Mininni: “Real estate deals may profit from mathematical reductionism; life does not” (Vischer 2004).

6. Conclusion

Regardless of all the arguments against Kravinsky’s philosophy, one should note the goodness of his deed. In saving a life through a non- directed kidney donation, he accomplished an act of generosity few would, or could, duplicate. Kravinsky is also happy with his choice. He notes that giving away his kidney gave him “joy” in return. Likewise, there are no regrets:

[I]t was not a letdown. That joy still comes back from time to time. It was unselfish, and that can’t be taken away by subsequent events. It gives me a security. In theory, I can’t get too depressed because I did this one good thing. My claim is that my aim in life is not happiness but goodness. I can’t conceive of any purpose in life, if not moral advancement. (Psychology Today 2005)

The utilitarian inspiration for such moral advancement, however, arguably lacks the moral core that Kravinsky appears to boast. The product of any widespread adoption of maximum human utility and its centerpiece, lethal organ donation, would be a cycle of renunciation without end, in which there is no room for any objectives other than reaching a model of sacrifice that materially and aspirationally levels almost everyone, save those who are extinguished for the perceived common good. There must be better options.

References

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