You're a doctor, and you have 4 patients, 3 of them need transplants - a heart, liver and kidney respectively

Question

If don't get these transplants immediately they'll die. The 4th patient is braindead. By some miracle, the braindead patient happens to be a perfect donor match for your other 3 patients, so can save all their lives if you use his organs. You're in a position to take patient 4 off ventilation and, for whatever reason, there is zero percent change you'll get caught. Do you kill patient 4 to save the lives of the other 3? If not, why?

To those picking on the details of this - don't. It's obviously not the point. Of course they wouldn't be matching donors, of course you couldn't be 100% sure of getting away with it. But I'm stipulating those conditions - I'm asking what you'd do if those things were the case. It's a thought experiment, I don't have 4 patients here waiting on a decision.

Answer 1

Brain dead means dead. So yes I would.

Answer 2

If you ever took precalculus or some other math class which covers properties of functions, you learn how to determine the domain of the function. One of the red flags to look out for is when you divide by zero. In your expression, when x = 3, the denominator is zero. Thus, the domain is every number beside 3. Unfortunately, the number you are trying to plug in (x = 3) is the only number that doesn't work in this function. To see this first hand, you0 can graph this function on a TI-83. If you zoom in on the point of the graph at x = 3, you will see that there is a blank spot there! That is because, as stated above, there just isn't a value of the expression at x = 3. You may say, well it looks like the answer should be 6, looking at the graph. This concept of what the answer "should be" is what limits are all about. The values of the function on the left and right of x = 3 all go towards 6 as you get closer and closer. So we say the limit as x goes to 3 is 6. So even though it is not technically the answer, 6 is your best choice. Zero is absolutely not correct in any sense. The very best answer is to say that the expression is undefined at x = 3. This problem illustrates why 0/0 is called indeterminate. In this problem, 0/0 in a way equals 6. The idea that 0/0 can equal anything is actually the essence of calculus.

Answer 3

My mother in law - this happened to her - but the doctor had to wait and get permission from the family before letting her off the ventilator - this is a code of ethics that any good doctor must abide to - if not, he or she should get out of the practice.

After explaining to my family of her condition and that she was already braindead, but kept alive with the ventilator - and also explained that her organs would help other people if they would be interested in donating - which also was the family's decision (remember NOT all people sign the area where they want to donate organs if when they die).. the family did agree, and I know for a fact that the other people survived.

So, i think any respected physician, would follow the ethics of the profession and do what is needed and follow the rules, but not sit on their butt thinking about it.... get to the family of the fourth patient and talk to them, explain to them.. and give the respect to them to make a good decision. If they do not, then the physician has done what he could.. just as equal going against his ethics knowing all the complications and possiblities that can happen in any operation; meaning the other 3 MAY have survived, but you would never know - possible infection or their bodies reject the transplant.... and if that happens you have 3 families filing lawsuits against the physicians bad ethics and responsibilities as a physician....

This was typed really fast, but this did happen to my mothe in law and all I know is that they family needed to know everything..

Answer 4

There really is no easy answer. Though someone may be braindead, it is not the braindead person I would be worrying about. Even though there is 100% chance that I would not get caught, I would know what I did to the friends and relatives of the braindead individual and I would have to live with the fact that I snuffed the last bit of life out of their hope as I snuffed the life from the braindead body.

As for the three I could save, who am I to determine who's life is more important than another's? Would the three that were saved have a good quality of life? Though I could save a greater NUMBER of lives by harvesting the life of one, I may not be actually bettering the world in any way. I might even be making the world a worse place. Every action sends ripples throughout the world.

I could not truly answer that until I was in the situation, but I think I would end up saving the three lives at the cost of the one that is really more like 1/2, though this sort of thing is the reason I have no interest in being a doctor. It is just not my place in the world.

Answer 5

If patient is brain stem dead, the organs cannot go to the three patients unless they were a match, and there are thousands waiting, but the organs have to be kept alive in order to carry out the transplants, the longer they are out of the body, the worse they become. So you would have to keep patient 4 on ventilation. Your other 3 patients if they came up as a match on the transplant list, they would have to have blood test to make sure they are fit for surgery.

Regarding heart and liver, there is a prioty list, but not for the kidney. You wouldn't be able to carry out the transplants without the transplant co-ordinator.

Yes the three patients need transplants but so do the rest of the list, so more than 3 peoples lives would be saved. Also what happens if say, God forbid, you or one of your family members needed a transplant and this was to happen in the future?

Anyway as a Doc your priorty is to save lives, which you would be doing by allowing the organs to go to the best suited patients wherever they may be. That is if the 4th patients family agree to organ donation.

So in answer to your question, I would contact the transplant co-ordinator and follow correct procedure, its not up to you to decided who gets the organs.

As for car crash victims again it all depends how long they have been dead, time is very crucial.

Jenni - kidney transplant Feb 06 - glad you were not my Doc!!

Answer 6

You like asking questions like this don't you?

Yes, I would perform all three transplants since I consider the donor's life to be preserved by only artificial means and the circumstances justify terminating that and allowing natural death to occur.

Far from not 'getting caught' I would wish to declare my actions to the authorities concerned and hope to be supported in my decision by them.

I could go on about other considerations but I'm staying within the parameters of your question.

PS: There's always something. No, luv_life918, Catholicism does not consider this murder and actually provides guiding principles to cover the eventuality. I would be surprized if other faiths and civil authorities did not make similar provisions.

Answer 7

1st is patient #4 an organ donor? 2ed you talk to the person with in charge of making these decisions for #4. If that person says yes and indicates that #4's organs should first go to #'s 2,3,4. Then and only then do you pull the plug. No as the doctor you don't make that decision and kill someone.

Answer 8

Doctors have to follow a code of ethics. If the brain-dead patient's family removed the life support and the patient clinically died, then sure, the organs can be transplanted. But so long as that brain-dead patient is aliive, even though its only through the aid of a machine, the code of ethics needs to be followed.

Answer 9

well all donor organs come from brain dead patients, or have to be mechanically kept alive. Isn't that how it works anyway except that the doctor has to have consent from the next of kin from the prospective donor, and a second opinion HAS to be made of the same diagnosis before any transplant went ahead.

That's how i thought it worked....????

Answer 10

I couldn't just sit around and do nothing like my doctors suggested.

They didn't want me to do anything or to take herbs or herbal remedies, but I had to try something - they just wanted me to do dialysis!

This program allowed me to take control of my health. I went from Stage 4 to Stage 3 kidney disease.

It was easy to do and my BUN, creatinine and anemia are all in better ranges.

Reversing Your Kidney Disease?

Answer 11

No, it is unethical. You don't know if patient 4 is a donor or not and there are others on waiting lists for those organs if that patient is a donor.