AN UNLIKELY SLIPPERY SLOPE

She gave of herself: Ethicists debate the case of a doctor who donated one of her kidneys to a patient (Julie Smyth, May 01, 2003, National Post)

Last January, Hermelinda Gutierrez, a 33-year-old mother of two, walked into Dr. Susan Hou's clinic in suburban Chicago to be assessed for a kidney transplant. She had a life-threatening genetic condition known as polycystic kidney disease -- she had developed cysts on her kidney, causing the organ to shut down.

She would need dialysis treatment and, without an immediate donor, would be placed on a minimum four-year waiting list for a new kidney.

Dr. Hou, the medical director of kidney transplants at Loyola University Medical Center, knew of a donor who could give the young mother a new chance at life. She cross-checked blood types and determined that Ms. Gutierrez would not likely reject the organ, then called the woman back into her office.

She told Ms. Gutierrez she was the donor -- she wanted to give her own kidney.

Dr. Hou had spent the last 30 years searching for someone to give her healthy kidney to -- it was something she had wanted to do ever since she watched a friend in medical school suffer from kidney failure. She had offered her kidney to two friends, including the one from university, but there either had been a family donor or it was not a suitable match.

In Ms. Gutierrez's case, all of her family members -- her husband and siblings -- had been tested but they were unable to donate a kidney to her.

"She had a great family but they all had the wrong blood type. It wasn't like I felt there was someone else who should be doing it. She just needed a kidney," said Dr. Hou.

"The wait in Chicago was four or five years; her kids are seven and nine, so she would be limited in what she could do with them until they were 12 and 14. That is a long stretch in a kid's life." [...]

In October, the kidney specialist became what is believed to be the first doctor in the United States to donate an organ to a patient. The transplant, which has only recently been made public, has sparked an ethical debate. Dr. Hou continues to treat Ms. Gutierrez, leading ethicists to question whether she has crossed a line in her professional relationship. They argue that she cannot be objective when treating a patient carrying her organ.

Arthur Caplan, chairman of the department of medical ethics at the University of Pennsylvania, said doctors should never enter into such a personal arrangement with a patient, just as doctors should avoid treating their own family members. He questioned how a doctor would react if that patient stopped taking medicines needed to keep the donated organ healthy, or how that physician would feel if the transplant failed.

"I think this donation crossed a moral line. It becomes emotionally very complicated. There is also a danger that you are going to be seen as playing favourites if you deal with people who are on dialysis all day long and you pick one of them to give your kidney to." Dr. Hou has more than 400 patients on her clinic's transplant waiting list.

If this is unethical, then the ethics is a ass. Just consider what Mr. Caplan is worried about here--do you really think we face an epidemic of doctors offering their organs to their favorite patients? I know several doctors who wouldn't donate urine if a patient was ablaze. Dr. Hou did a beautiful, life-affirming thing. This should be our culture's biggest ethical problem. Posted by Orrin Judd at May 1, 2003 12:05 PM