Renada's Case Study

Dear colleagues, please note a sensitive case has been brought to us to deliberate on. David, who is a father, has requested to donate his second kidney to his daughter, Renada. What is more, she urgently needs to undergo a kidney transplant. As you know, the matter has gained the attention of the entire country, and it is our duty to ensure that we solve the case with utmost care using the applicable principles of bioethics. Renada’s case is very challenging and sensitive because we have to balance two critical aspects. Either we agree to grant Renada’s father his wish of saving his daughter and possibly harm his health in the process, or we go against the request and save his life and millions of taxpayers’ money that would be used for his dialysis after the operation. I would like to draw your attention to the respect of autonomy as per the principles of bioethics, which lays emphasis on the practice of informed consent. According to the case at hand, David Patterson, who has been sentenced to 12

years in prison, has offered to donate his last kidney to his daughter, whom he loves very much.
You must also be aware of the prima facie logic of the patient’s autonomy in this case. David already knows very well the predicament that he is likely to face if he is granted his wish. He is putting his life in danger by donating the only kidney he has left, and he might die in the process. The case is further convoluted by the fact that David is aware of all
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these consequences, yet he still insists that his daughter must receive the transplant. According to the respect for autonomy principle, doctors are supposed to grant him such a wish because there is informed consent to proceed with the operation. Ladies and gentlemen, time has come for my team to make a choice between taking the life of one individual to save another, whose chances of coping with a new kidney are slim, and ignoring the request altogether due to the resultant cost implications. However, this scenario presents a conflict of interest in the sense that the doctor has a moral duty to prevent harm to their patient and at the same time obey their wish.
On the contrary, I would like to appeal to the principle of justice outlined in bioethics, which promotes fairness in medical practice.

You all know that this principle suggests that everyone should be given what they are entitled to and what belongs to them. In line with this argument, and considering the case at hand, both the girl and her father have a right to be given their dues. However, we have to consider other factors beyond the justice principle. The girl has the right to obtain the remaining kidney from her father as promised while he also has a right to accomplish his wish of saving his loved one. Nevertheless, the underlying question in this case that we need to answer is whether the principle of justice will outweigh the principles of beneficence and nonmaleficence.
Dear colleagues, let us now consider the above principles of bioethics with regard to the case at hand. You all know that the principle of nonmaleficence dictates
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that we should avoid intentionally injuring a patient at all cost through medical practices, including by omission or commission. My team has looked into the girl's case and found that there is a possibility of the two individuals, including Renada and her father, dying after the transplant. Renada’s body system is likely to reject the kidney since her body has already become incompatible with the first two organs (her original kidney and the first kidney from her father). Besides, when the girl failed to take the medicine she needed to improve the efficiency of the transplantation process, her face became bloated, her stomach distended, and eventually, she became very sick. Such symptoms recorded by the intended recipient show that her body might have illustrated that David was no longer a suitable donor. Therefore, there is a possibility that the kidney will fail once transplanted to Renada’s body. On the other hand, her father cannot survive without any kidney unless he is given special care under dialysis, which will also come with serious financial implications. Performing the transplant will be seen as a sheer negligence since every sound medical professional is aware of the looming danger of carrying out the procedure.
As the administrator of Stanford Health Care, I would like to support what my hospital’s mission statement stands for, which is healing humanity through translational medicine using exceptional quality, coordination, and compassion. With regard to these organizational goals, I believe it would be best for her father not to donate his second kidney. On behalf of the hospital, we value the health of all our patients and would not wish to encourage procedures that might harm
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them. In line with the principle of nonmaleficence, I believe that we have a moral duty to obey and balance the consequences of this case. This can be done with the help of the double effect principle that is clearly outlined in the nonmaleficence code. It would be prudent not to allow David to proceed with the donation; it would not be intrinsically wrong on the part of the hospital administration, as we would save him from harming himself. On the other hand, it is unfortunate that as a result of the decision, Renada would have to seek another donor. However, we are hopeful she will find one as soon as possible. She has to understand that receiving the only kidney from her father may kill him. Besides, if the kidney fails in her body due to her possible incompatibility with the same organ, both of them may pass on.
Besides, as the hospital administrator, I must also look at the financial implications of allowing Renada’s father to donate his kidney to his daughter. After David gives the only remaining to his daughter, the only procedure that could keep him alive is dialysis. Since her father is in prison, the state will have to pay for the medical expenses incurred from his operation. In addition, the taxpayers’ money will be used to cater for his dialysis. Therefore, the case stands resolved as follows: Stanford Health Care cannot allow Renada’s father, David, to donate his second kidney to his daughter because of two reasons. The first and the most significant one is the fact that the procedure may not be successful on Renada, and both of them
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could die in the process. Secondly, because David is a prisoner, undergoing dialysis for life as a result of the operation will be a huge burden on taxpayers’ money.