From the Tennessean

By CLAUDIA PINTO
Staff Writer

Pam Melson wants to donate one of her two healthy kidneys to a dying friend.

But officials at the Waynesboro, Tenn., factory where she works refuse to give her time off, even without pay ? a decision that a business ethicist and organ donation experts find troubling.

“They said letting me off to get this surgery would be like someone getting let off for getting breast implants,” said Melson, who has worked at the factory for four years. “I think what I’m trying to do is a little more important than getting breast implants.”

Dave Roberts, Tennessee Apparel’s vice president of manufacturing, said he’s not trying to discourage Melson from going through with the donation. But, he said, the Tullahoma-based company won’t hold her job for her.

“If she decides to do that we’ll give her every consideration to come back to work,” he said. “She would come back as a new employee.”

Melson, 31, is her family’s sole financial provider since the store where her husband worked went out of business, and she said she can’t afford to lose her job.

So, the transplant operation originally scheduled to take place this month at Vanderbilt University Medical Center has been postponed until officials at Tennessee Apparel relent or another donor is found.

Wait can be years

While the operation may be elective for Melson, it’s not for 36-year-old Donnie Hammack, who is married to Melson’s distant cousin.

Hammack’s transplant surgeon, Dr. Mark A. Wigger of Vanderbilt, said he could probably survive for another five years. But if Hammack relies on the national waiting list to get a kidney, he could die waiting.

Average wait times are anywhere from two to five years, according to Janet Jarrard, Tennessee Donor Services’ public education coordinator. However, Jarrard said, she’s heard of people waiting for as long as 10 years.

In 2006, 4,079 people in the U.S. died waiting for a kidney. Eighty-five of them were Tennesseans, she said.

Absenteeism is an issue

Tennessee Apparel’s Roberts said the primary reason Melson’s request was denied is her “excessive absenteeism.” He declined to say how many days she’s missed.

Melson, who works onmilitary pants manufactured at the factory, said she gets one week of vacation each year. She said she’s missed more than a month of work this year, primarily to care for her children when they were sick.

“I have three children. When they are sick it’s my job to take care of them,” she said. “I told (the company)don’t ask me to pick my job over my kids because I will not do it.”

Despite her absenteeism, Melson and Hammack don’t understand why company officials won’t grant her a four- to six-week leave, considering that she isn’t asking to be paid and Hammack’s Medicaid would pay for medical expenses.

“My reaction is the guy has no heart,” Hammack said.

Bart Victor, a business ethicist with Vanderbilt University, said the situation boils down to the argument of whether a business has one obligation ? to its shareholders ? or to all of its stakeholders, including the employees and the community.

In this situation, Victor said, it’s difficult for him to understand why the company would say no.

“She is making a courageous and very generous offer for this man,” Victor said. “It’s a decision of life. It’s a decision of charity. It seems to be a relatively minor sacrifice to them.”

But Roberts said of giving Melson time off: “We would have to put someone in her position.”

Employer isn’t obligated

In Tennessee, an employer has no obligation to provide time off for such situations, Roberts said.

Roberts said that he consulted the federal Family and Medical Leave Act when making his decision and that Melson doesn’t meet the requirements. The act demands employers provide 12 weeks of unpaid leave for employees “to care for a child, spouse, or parent with a serious health condition” or “for the employee’s own serious health condition,” among other situations.

“It’s not a family member,” Roberts said. “This is an elective surgery based on her own decision. She doesn’t have to do this.”

Seventeen states have passed legislation to encourage organ donation. Seven require employers to give organ donors a leave of absence from work. The other states offer donors a tax break. Some do both, according to the United Network of Organ Sharing.

Tennessee is not one of those states.

Also, under the Organ Donor Leave Act, federal employees who volunteer to donate organs are entitled to 30 days of paid leave. However, Tennessee Apparel is not a federal agency.

Dr. J. Harold Helderman, medical director of Vanderbilt’s transplant center, said the issue is much bigger than the plight of one man. He said there is a great need for more live donors because there are simply not enough organs from deceased donors to meet the demand.

There are 71,935 people waiting for a transplantable kidney in the United States, including 1,407 in Tennessee, according to the United Network of Organ Sharing.

Melson would like nothing more than to be responsible for subtracting one of those numbers, but with three children she says she just can’t afford to lose her job.

“Around here it’s probably the best-paying job” besides one at a local prison,” Melson said.

Donnie Hammack’s kidney began failing more than a year ago, leaving him unable to go to the bathroom and feeling constantly tired.

He travels more than an hour to Columbia three times a week to have a machine do what his kidneys no longer can. During a three-hour procedure, known as dialysis, waste products in Hammack’s blood are cleaned out.

“You really can’t do nothing,” he said. “I’ve got a teenage son. I can’t do stuff with him. It just tires you out.”

Kidney closely matches

Melson knew Hammack was suffering and offered to help. There was only a 1-in-500,000 chance that she would be a match.

As it turned out, “I was so close a match they thought I was his sister,” she said.

Indeed, Melson was an even better match than Hammack’s own sister. He has three full sisters ? one was not a good match and the other two have health issues that wouldn’t make them appropriate donors.

“That’s an amazing person who will do that for me,” Hammack said. “I can’t explain the feeling.”

Melson plays down her compassionate gesture, saying she was raised to believe that if you can help someone you should.

“What better reason than to save a man’s life,” she said.