Recent controversy has arisen from the case of a young child requiring a kidney transplant, and his father, a perfect match, who was prevented from donating his own kidney due to legal problems. Father Anthony Dickerson, who had several prior arrests, was initially approved to donate his kidney to his son AJ, but the scheduled surgery was postponed after he was arrested last month for violating parole. Despite his arrest, it was reported that the transplant organization and county jail organized the father's monitored release for surgery, but the hospital personnel had halted the procedure.
AJ's mother released a statement that the child's health was being impacted due to his father's personal mistakes. This leads to the question- is it moral to allow the actions of a parent to endanger a child's well-being?
News articles simply state that the child was born "premature" and "without kidneys" without further specification. Babies born premature are at increased risk of severe renal consequences due to the disruption of organogenesis. Specifically, nephrogenesis continues into the late fetal period, approximately week 35, with 60% of nephrons (the functional unit of the kidney) formed in the last trimester. Specific details regarding the child's prematurity and health complications were not shared.
While awaiting negotiations between the hospital, the transplant program, and the district attorney, AJ remained on the transplant list. This week, a recently-deceased donor became available, and two-year old AJ underwent a successful transplantation the day before Thanksgiving.
Seemingly, this seems to "solve" the ethical problem of the father being prevented from donating his own kidney to his son due to legal problems. But instead it now raises the question- if the child's father was an eligible and willing donor, did they prevent someone else from receiving the transplanted kidney? Did they steal this life-saving organ from another deserving recipient, instead opting to provide treatment to only one person instead of two? In my opinion, this violates the biomedical ethical principle of justice. It allocates a scare health resource to an individual who had another viable option, thus inhibiting the beneficence of another.
SOURCES:
Press, A. (2017, November 23). Boy, 2, gets kidney transplant after initial surgery delayed over dad's arrest. Retrieved November 25, 2017, from https://www.nbcnews.com/news/us-news/boy-2-gets-kidney-transplant-after-initial-surgery-delayed-over-n823641
Bever, L. (2017, October 16). A 2-year-old’s kidney transplant was put on hold - after his donor father’s probation violation. Retrieved November 25, 2017, from https://www.washingtonpost.com/news/to-your-health/wp/2017/10/16/a-2-year-olds-kidney-transplant-was-put-on-hold-after-his-donor-fathers-probation-violation/?utm_term=.02a58a31d668
Stritzke, A., Thomas, S., Amin, H., Fusch, C., & Lodha, A. (2017). Renal consequences of preterm birth. Molecular and Cellular Pediatrics, 4(1). doi:10.1186/s40348-016-0068-0
Hill, M. (2017). Embryology: Renal System Development. Retrieved November 25, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Renal_System_Development#Introduction
What an interesting case, Melanie! The thought that kept going through my head was how is everybody's autonomy affected by this situation? When someone is incarcerated, they lose a degree of their autonomy. They lose the privilege to vote and otherwise function within society. But what ought we to do when an incarcerated individual is seeking to medically assist another non-incarcerated individual? Should they be deprived of their autonomy to save another's life? Additionally, should the child's autonomy be violated by removing the possibility of access to a promised organ?
ReplyDeleteAnother situation in which this may occur is if a bone marrow donor who is designated a "perfect match" ends up being an incarcerated individual. Should they still be allowed to donate? Let us remember that to have the best odds of finding a "perfect match" we must find someone who is the same race as the patient. If an African American patient finds a match on the bone marrow registry, there is an 80% chance that the identified donor is the ONLY match on the registry (Institute for Justice, 2017). So, should the patient lose the ability to have an incarcerated individual serve as her donor and should the incarcerated individual lose the ability to save someone's life? My answer is: absolutely not. That would be an atrocious violation of both parties' autonomy and justice.
Institute for Justice. Bone Marrow Statistics. Retrieved November 26, 2017, from http://ij.org/bonemarrowstatistics/
I agree with Alexandra, this case is very interesting! The hospital only asked that the boy's father, Dickenson, be escorted to the hospital for the surgery, not that he be released early or have his bonds lowered. However, this was the Gwinnett County Sheriff's Office's response. The hospital then asked for "evidence that Dickenson was complying with his parole officer" (Bever, 2017).
ReplyDeleteI understand that the hospital was probably fearing backlash on getting Dickenson's parole date moved up and his bond lowered. However, should the hospital's top priority be saving people's lives and not concerning themselves with how people live their lives outside of the hospital? On what grounds was the hospital able to make demands such as ensuring Dickenson was in compliance with his parole officer?
One prisoner, Shannon Ross, from Stanley Correctional Institute in Stanley, Wisconsin wrote an opinion article in The New York Times about why he thinks prisoners are not allowed to donate organs. Ross names cost, potential for abuse (such as in China), and the high disease rate among prisoners. Ross believes that allowing incarcerated individuals to be organ donors would have a significant impact. “Indeed, just 5 percent of us could eliminate the kidney waiting list” (Ross, 2013).
Sources
Bever, L. (2017, October 16). A 2-year-old’s kidney transplant was put on hold - after his donor
father’s probation violation. Retrieved November 25, 2017, from
https://www.washingtonpost.com/news/to-your-health/wp/2017/10/16/a-2-year-olds-kidney-transplant-was-put-on-hold-after-his-donor-fathers-probation-violation/?utm_term=.02a58a31d668
Ross, S. (n.d.). With Organ Donations, Let Prisoners Give Life to Others. Retrieved December 04, 2017, from https://www.nytimes.com/roomfordebate/2013/04/25/should-prisoners-be-allowed-to-donate-their-organs/with-organ-donations-let-prisoners-give-life-to-others