Case 5: Bone Marrow Transplantation- Mentally Incompetent Donor

Case 5: Bone Marrow Transplantation- Mentally Incompetent Donor

Case 5: Bone Marrow Transplantation- Mentally Incompetent Donor

Mr. Williams suffered a severe brain injury in a road crash and resides permanently in a care home. He is regularly visited by his family and it is clear that he is very happy with these visits. His brother is a constant visitor. He (the brother) has been diagnosed with a condition that can be treated only by way of a bone marrow transplant, and Mr. Williams is almost certain to be a match. He cannot, however, give his consent to donate bone marrow, as his brain injury is such that he cannot make a decision and would not understand what was being done. However, the family asks the doctor, “Does that mean that he cannot be a bone marrow donor?” “What account is to be taken of the benefit he enjoys from visits from his brother?”

Please discuss the alternatives and justify your answer. How should the doctor decide?

1. The donation should be performed because there is a benefit to Mr. Williams too. He preserves the life of one of his visitors and the risks of bone marrow donation are much lower than the risks of an organ donation.

2. The donation should be performed because it cannot be assumed that someone who has no capacity to make their own decision is thereby deprived of being altruistic: it merely means that an alternative process of decision-making has to be adopted.

3. The donation should not be performed because there is (even a minor) health risk to Mr. Williams and a donation is not in his best interest, as he is not the recipient of necessary treatment.