We have another transplant case with which we need your help. Dr. Roberts has a patient, Ms. H, who is critically ill and in need of a liver transplant, but she is not a good candidate. Ms. H has a large tumor on her liver that would likely resurface after surgery. Dr. Roberts estimates her chances of success after surgery at below 4%.

Unfortunately, Ms. H also has a very low platelet count, so she is also unable to take Interferon, the only other treatment for someone in her condition.

Given Ms. H’s condition, most physicians would not operate, and Dr. Roberts has said that he believes the operation to be unwise, given the risks to both the patient and donor, and the low likelihood of success. However, Ms. H’s brother is a suitable donor, and both parties insist they want the surgery performed – despite the risks.

Dr. Roberts has carefully explained to them all the risks of this operation, given Ms. H’s condition, and the very low likelihood of success, but Ms. H and her brother are adamant about proceeding with the surgery. Ms. H claims that she has the right to determine her own medical treatment, and her brother insists that he’s willing to donate part of his liver, despite the risk to his own health, and that he has the right to make this choice.

We will be reviewing this case and making a policy recommendation, just as we did with Dr. Smith’s methadone patient. I will email you details on the next steps shortly.

Thanks,

Chris Jones, M.D.
Chair, Ethics Committee
Lincoln Regional Medical Center