Case 6: Parental Kidney Donation

Case 6: Parental Kidney Donation

Case 6: Parental Kidney Donation

John is a 12 year-old child who is in need of a kidney transplant. John’s parents (Mr. and Mrs. Smith) are both willing to undergo parental live kidney donation. They have explained that this is “natural” to them; it is a matter of “parental responsibility”. Mrs. Smith has explicitly said that if one has brought a child to this world, one should do what one can for the child’s health and well-being. Both parents have also explained that they are more than happy to start the medical test and examination procedure, which will show whether they are medically acceptable as donors. However, when Mrs. Smith underwent the procedure, the doctors found that she could not be accepted as donor since she has a cyst on one of her kidneys. For Mrs. Smith these were “just terrible” news. The medical professionals turned to Mr. Smith explained that he really wanted to donate. Today, however, Mr. Smith gets the response that he is medically unacceptable as donor because he has rheumatic fever. Mr. Smith already knows this and he gets upset. He explains that, in his view, it is better that he donate now, while both of his kidneys are ok. They may get destroyed later on in life, he says, and “it is better that my son gets one of them, while he’s healthy and young. He adds that he thinks he has the right to decide on his own what happens to his body. The ethical committee and physician involved are unsure how to decide as the surgeons do not want to harm the donor which means exposing the father to serious health risks. On the other hand the parents insist in their “parental responsibility”.

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

1. The doctor rejects Mr. and Mrs. Smith’s offer of becoming donors, because the risk in the future is too high.

• The doctor agrees to Mr. Smith becoming a donor for his child, because of his expressed decision to give his life for the life of his son.

• The parents should reconsider what they mean by “parental responsibility” and how this risk will also affect their son psychologically. The transplantation will be postponed and the Mr. Smith will not be allowed to donate, because his ability to make an autonomous decision seems to be seriously weakened by an overstated understanding of “parental responsibility”.