To:
Transplant Department
From:
Lead Surgeon
Date:
September 13, 2014
Re:
Heart Transplant Recipient
On September 13, 2014, I was informed that a heart had become available for use as a transplant. At this time, there are three possible recipients who are a match for this organ. Jerry is a 55 year old male, Lisa is a 12 year old female, and Ozzy is a 38 year old male. After reviewing each of their cases, I am prepared to make an ethical decision as to who will receive the donor heart. Based on utilitarian and deontological ethics, I have decided that Ozzy should be given the transplant as it will have the greatest benefit and do the least harm in this situation.
Jerry is currently in the ward right now waiting for transplant. Should he receive the surgery, his life expectancy would be another 10-15 years. He is 55 years old, married, and has three children aged 14, 16, and 19. The youngest child is mildly autistic and in need of extra care. His wife is a homemaker and has no education beyond high school. It would be very difficult for her to become the sole provider for their children should Jerry succumb to his heart condition but there are services available to help assist the family should they lose him. The family also has each other to lean on. Jerry’s condition was caused by steroid use in his 20’s, before its ill effects were known. He had no way of knowing the terrible outcome his decision would have. Jerry has worked his way up to middle management at the carpet distributing business he is employed at and is only 5 years short of retirement. If Jerry receives a transplant, he has a very high probability of survival after surgery and should be able to return to work to support his family. Jerry’s health at this time is not as critical as Ozzy’s so he does have time to wait for another heart to become available.
Lisa is a 12 year old female and she is the only child of Dr. Doe, an oncologist who works at this hospital. Lisa has sadly had to deal with health issues for the entirety of her short life because of several viral infections made worse by an immune deficiency. If Lisa receives the transplant her life expectancy and quality of life are not anticipated to be ideal. A transplant would buy her some time but not much. Due to the fact that her immune system is already depleted, the immunosuppressive drug therapy needed after transplant could wipe out her immune system altogether and that would be devastating. I do not believe that her health is strong enough at this time to endure such an involved surgery. Dr. Doe has offered the hospital $2 million if Lisa gets a transplant which is a tempting offer since the money is needed and could help countless people with the improvements the hospital could make. However, a donation in exchange for an organ is unethical and presents a conflict of interest. It is understandable that Dr. Doe and his wife would want to do everything possible for their child, as any parent would but accepting that donation creates an unfair advantage for people who have money as opposed to those who don’t. That is not a precedent that I want to set. The Doe’s are young and well enough off financially that they could adopt another child eventually since they cannot have any more biologically.
Ozzy is a 38 year old homeless male with a past of severe drug use. He will not survive the month if he does not