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Ethical Scenario 12
You are a renal transplant specialist working in a hospital. A kidney becomes available for transplant, and there are 2 patients who require a transplant. The first is a 60 –year-old woman, who has developed renal failure as part of an autoimmune disease. The second is a 24-year-old man who has developed renal failure due to substance misuse.
You are only able to transplant the kidney to one patient, who do you choose?
You are only able to transplant the kidney to one patient, who do you choose?
Average candidate approach
- ‘The woman has developed renal failure through no cause of her own, and therefore she should receive the transplant’
- ‘The man is younger, and therefore is likely to survive longer’
- ‘The man may continue to use drugs, and therefore the transplant may be wasted on him’
Excellent candidate approach
To ensure the decision was made fairly, many factors have to be considered. I would estimate the increase in quality of life for both patients, and then compare them. I would try to calculate the QALYs to give a realistic estimate of the benefits of the transplant for each patient. I would assess the potential compliance of each patient – to ensure that the future lifestyle is compatible with the transplant. Someone who is likely to abuse substances and use/continue to use drugs is unlikely to “look after” the new kidney. From a biological perspective, considering the tissue matching of the organ is important. If the organ is not compatible, the patient will reject the organ.
To ensure the decision was made fairly, many factors have to be considered. I would estimate the increase in quality of life for both patients, and then compare them. I would try to calculate the QALYs to give a realistic estimate of the benefits of the transplant for each patient. I would assess the potential compliance of each patient – to ensure that the future lifestyle is compatible with the transplant. Someone who is likely to abuse substances and use/continue to use drugs is unlikely to “look after” the new kidney. From a biological perspective, considering the tissue matching of the organ is important. If the organ is not compatible, the patient will reject the organ.