No reality television programme has played for such high stakes: three nervous candidates will be competing in front of a prime-time audience this week for a life-saving kidney operation, as the Big Brother format gives way to The Big Donor Show.

The macabre contest will be broadcast in the Netherlands on Friday. It is produced by Endemol, the maker of Big Brother, which is about to begin an eighth series in Britain. But while the worst that can happen in Big Brother is public humiliation, the Big Donor rivals are battling for their lives.

Lisa, 37, a terminally ill cancer patient, has agreed to donate a healthy kidney. She was unhappy about anonymous donation and wanted to establish a connection to a deserving person with kidney disease: that way her family could feel that her death had helped to keep someone else alive. But how, said Lisa, could she choose one life over another? How could she make the process less random?

The choice has been left to the television audience. A short film will be shown about each candidate depicting his or her life, family and friends. The candidates will be interviewed and spell out their dreams for a fulfilled and successful life. In the manner of Big Brother or the Eurovision Song Contest, viewers will register their choice by text message.

The identity of the contestants has been kept secret to prevent any lobbying; all that is known is that they are Dutch and aged between 18 and 40.

Politicians across the party spectrum are enraged and flabbergasted. The issue is to be discussed this week in parliamentary question time, with pressure mounting on BNN, the private broadcaster, to drop the show. Joop Atsma, spokesman on media affairs for the conservative CDA party, said that he wanted the whole thing dropped. “BNN won’t solve the question of organ donations with this show.”

The broadcaster, whose target audience is young people, has a reputation for being provocative. Its track record includes showing an anchorman taking the drug LSD, a supposedly educational programme on sex, entitled This is How You Screw and a weight-loss competition Help! My Dog’s as Fat as Me. There is more than a sliver of suspicion that it is exploiting illness for ratings.

The network, however, says that it merely wants to highlight the long waiting lists for donor organs. One of its leading entertainers died five years ago after failing to get a new kidney.

“The contestants in the show have a 33 per cent chance,” said Laurens Drillich, BNN chairman. “That’s a much larger chance than if they were on the organ waiting list.” Although some politicians are calling the show unethical, the main argument is that it violates good taste and is pushing the boundaries of acceptability.

Endemol, which also produces less provocative shows such as Show Me the Money, has often been the butt of criticism for its gladiatorial television formats. Much will depend on the production values, say the local TV critics: will the cameras, for example, linger on the faces of the candidates who lose?

“We are happy that the problems we have in finding donors is receiving publicity thanks to Endemol,” says Paul Beerkens, director of the Dutch Organ Donor Association. “But the way it is being accomplished is certainly not the way we would have liked.”

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