Informed Consent and Organ Transplants

INFORMED CONSENT AND ORGAN TRANSPLANTS By: Claire, Ceniya, Stefano, Lanie, Jacob, Gabby, and Caroline INTRODUCTION o Concern: Should transplant recipients know the lifestyles of their donors? Does the patient then have the right to refuse the donation? o Persons involved: o Donor: 38yr old homosexual man o Jane Doe: Developed HIV & Hepatitis from her donated kidney o Organizations involved: claimed to have known about donor’s ‘risky lifestyle’ o University of Chicago o Gift of Hope Organ & Tissue Donor Network INTRODUCTION Though the organizations knew the donor’s lifestyle, the patients were not informed of this before receiving the organs. ● The issue is the donor was a 38-year-old homosexual man who was sexually active ○ By CDC guidelines, they should not be used as organ donors unless the patient is in imminent danger of death. ○ We do not know the condition of the woman involved in the case, nor the other patients who received his donated organs. ○ 4 people were infected with HIV & Hepatitis INTRODUCTION ● ● Jane Doe’s attorney argues a guideline violated in this procedure was not informing the patient about the donor’s status. ○ It does mention that the woman had previously rejected an organ based on another person’s lifestyle. Another issue argued by the lawyer is that the patient was not tested directly after the procedure for HIV. ○ She was only tested after another patient who received an organ from this donor tested positive for HIV and hepatitis. ○ These are both serious conditions that the donor recipients will deal with the rest of their lives, along with the additional medications and side effects of these medications, which put them at high risk for other opportunistic infections. ETHICAL POSITIONS ● Aristotle: The hospital and procurement center’s actions lacked honesty, justice, and practical wisdom by withholding critical information from the patient. A virtuous healthcare professional would have valued transparency, allowing the patient to make an informed decision. He would view their actions as unethical due to ultimately harming the patient’s ability to flourish. ● Kant: Kantian ethics requires acting according to universal moral laws and respecting individuals as ends in themselves. By failing to inform the patient of the donor’s high risk status, the hospital treated her as a means to an end, undermining her autonomy violating the categorical imperative. The actions of the hospital and procurement center would not be universalized under Kant’s framework. ● Virtue ethics: This ethical position is grounded in the cultivation of character and proper virtues such as honesty and consideration. The healthcare professionals had a duty to inform the patient and follow CDC guidelines put in place for patient protection. Their failure to properly inform patients of the high-risk organ donor and follow CDC guidelines violates virtue ethics. It emphasizes the importance of respecting patients’ autonomy by ensuring they can make informed decisions. KEY QUESTIONS ● ● To the University of Chicago and Hope of Life Donor Network: ○ Why was the hospital unable to inform the patient of the high-risk status of the donor? ○ Why did the hospital proceed with the transplant despite being aware of the potential consequences that could adversely affect the recipient's quality of life? ○ If the patients had not contracted HIV and hepatitis, would the fact that the hospital and donor network did not fully inform the patients still be morally wrong? ○ To Jane Doe: ○ Would know that the donor was high-risk influence your decision to consenting to the transplant? ○ Should the patient have the right to consent to risky treatment? FINAL JUDGEMENT As a group, we determined that the transplant procedure was unethical. We applied Kant's and Aristotle's ethics to guide us in determining if the procedure was ethical, as well as virtue ethics to provide a more foundational aspect to our conclusion on the case study. FINAL THOUGHTS ON DECISION-MAKING o An unethical decision was made when the patient was given organs from a donor who lived a ‘risky lifestyle’ (guidelines from the CDC). o Recipients should maintain the right to refuse an organ based on perceived risks, as this empowers them to make informed decisions regarding their health and well-being. o However, the disclosure of donor information poses the risk of stigmatization and can decline donor participation. o There must be clear and comprehensive guidelines. These protocols must strike a delicate balance between ensuring transparency for recipients and safeguarding the privacy of donors. COUNTER ARGUMENTS o o Was the patient in a critical condition or imminent danger of death in which they would need a high-risk donor organ? The patient had been on the donor waiting list for over six years. She was on dialysis and responding well. Within that time, she had rejected a potential donor due to his lifestyle. o The donor network tested the donor organs before surgery, and they came back negative for HIV and hepatitis. o The donor could have contracted HIV and hepatitis in the weeks prior to death, but not yet developed antibodies. The university and donor network failed to properly inform Jane Doe of the high-risk donor. Sources o “Atty: Woman Wasn’t Told Donor Was a Risk.” The Associated Press, 16 Nov. 2007. o "Chicago Hospitals Alter Organ Transplant Rules After 2007 HIV Infections." Kreisman Law Offices, 25 Jan. 2011, www.robertkreisman.com/medical-malpractice-lawyer/chicago_hos pitals_alter_organ/. Accessed 27 Oct. 2024. o "Transplant Patient a "Mess" After HIV Diagnosis." NBC News, 16 Nov. 2007, www.nbcnews.com/health/health-news/transplant-patient-mess-after -hiv-diagnosis-flna1C9464067. Accessed 27 Oct. 2024. THE END