JESSICA SANTILLAN - DUKE UNIVERSITY

HEART TRANSPLANT CASE STUDY

 

  by Gerald M. Morris, Executive Director of Legal Affairs at Holy Cross Hospital and Michael Funk, PA-C, Assistant Professor Nova Southeastern University

 

LEGAL AND FACTUAL

ISSUES

BIOETHICAL

ISSUES

Can an "illegal" have a transplant ahead of a U.S. citizen or legal resident?

Should "illegals" have transplants

-          Kantian  (autonomy, beneficence, non- maleficence and social justice)

-     Utilitarian (consequences perspective)

-     Virtue Ethics (looks to the character and motivation of the action )

How did she get first transplant?

-         Factual and Procedural Issues

-         UNOS Criteria

-         Limited "useful life" of organs as affects geographic distribution

 

Is the current method of criteria, waiting lists and distribution fair and "right"

 

 

How did she get the second transplant

-         UNOS Criteria

-         seriousness of condition

-          likelihood of survival

 

Is the current method of criteria, waiting lists and distribution fair and "right"

Declaration of brain death and family objection to removal from "life support"

-         Brain death vs. withdrawing life support

-         Consent

Should family be the final decision-makers when determining when death has occurred

Costs - who pays for all this

-   Fundraising by the well-intention

Allocation of limited resources

Demand by the money-raisers that the second set of organs be re-transplanted

 

Liability of Duke and physicians

-   error in not checking blood type

Should there be a different standard of care for such high-risk activity

What is the value of a wrongful death case

 

OPTN Data

Annual Report

Median Waiting Time Before Transplant (In Days)

 

ORGAN

1995

1996

1997

1998

1999

2000

2001

 

 

 

 

 

 

 

 

Kidney

813

881

975

1080

1151

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Pancreas

254

324

338

359

419

529

522

Liver

228

333

424

484

655

778

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Intestines

282

288

208

149

217

175

172

Heart

186

191

182

207

204

191

153

Lung

469

517

622

689

776

748

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Heart-lung

676

618

889

935

573

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