HON 365: Ethical Issues in Science
Case Study #1 – Heroism and Harm
Several
years ago, the mother of two children donated one of her kidneys to her son who
was diagnosed with end-stage renal disease.
Now, her 12-year old daughter has been found to have the same
condition. The daughter is currently
dialysis dependent and the mother wants to donate her second kidney to her
daughter. When asked, she said she
would rather deal with the dialysis herself while waiting for a cadaveric organ
than put her child through that. She
realizes that no organ is guaranteed, and even if one were to become available,
the wait could be several years.
Questions to ponder:
- What
is the physician’s duty to her patient? Are we harming the mother to save
the daughter? If so, is this
acceptable? If not acceptable, why
was it acceptable to harm the mother when she donated her first kidney?
- To
what extent should the physician advance the patient’s interests? Is a claim that this is a “medically
unreasonable” request reasonable?
If so, why is it unreasonable?
Should the mother’s psychological needs be taken into account? Assess the risk-benefit ratio for the
mother and daughter.
- Does allowing a patient to donate a second
kidney set a precedent that might subtly but unacceptably pressure other
parents or loved ones to do the same?
Is this “passive coercion” acceptable for donating one kidney but
not two?
- How is
this mother’s desire to support her child different than the case of a
mother who wishes to sell one kidney in order to secure money to support
her children?
Compliments of Greg, Loeben,
University of Arizona, Health Sciences Center