Expert Response 3

Updated: June 25, 2020

In this situation, I am faced with an ethical dilemma of giving an organ transplant to a successful elderly member of the community or to a 20-year-old drug addict. First, I must remain non-judgmental and gather information first. I must not jump to conclusions about age or the fact that one patient appears to have a dependence on drugs. First, I will ensure that both patients are indeed matches to receive this transplant. I need to find out about both patients’ conditions and what led them to requiring an organ transplant. I must also find out about the prognoses of both patients post-transplant. Which patient is more likely to recover and gain the most from this transplant, including not just quantity but quality of life? Since organs are a very limited resource, I need more information first. I also should not feel that only my opinion is important here. 

Healthcare is a team-based environment, and I should seek out others’ thoughts, including the patients’ physicians, nurses, other healthcare staff, and the hospital ethics or transplant board, which is often involved in finalizing these decisions. There are 2 outcomes here: either the elderly patient or the young patient. In either case, the decision will be made non-judgmentally and based on which patient will be able to have a strong recovery from this transplant. For the patient who does not receive the transplant, the healthcare team must discuss this with the patient and their loved ones, and ensure they understand that not receiving the transplant right now does not mean that we are going to stop treatment or looking for ways to improve their condition, and that they are still on the transplant list. Moving forward, I will ensure our hospital has a clear set of guidelines in place so organs are allocated on a non-judgmental basis with clear policies in place. To summarize, I would gather information and ensure we have been non-judgmental in deciding which patient to provide the transplant to, and ensure guidelines are in place for future situations like this one. Thank you and I look forward to addressing any further questions you have.

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