Introduction
A five-year-old girl with progressive renal failure is not responding well to hemodialysis, and a kidney transplant is being considered despite uncertain effectiveness. Tissue typing shows a poor match; her mother and siblings are incompatible, but her father is a match with adequate circulatory function. Meeting alone, the nephrologist explains the uncertain prognosis, and the father declines to donate due to fear and concern over the outcome, hoping for a cadaver kidney instead. He asks the nephrologist not to tell the family to avoid resentment, so the nephrologist cites medical reasons for his decision.
Identifying the Ethical Issues
In the case study, some ethical problems regarding a five-year-old girl can be noticed. She has progressive renal failure and a possible kidney transplant decision. The initial ethical dilemma centers on the dad’s choice, driven by personal apprehension and uncertainty about future outcomes, to avoid offering his kidney to his child and instead pinning hopes on a deceased organ donor. The second ethical issue is the father’s request for the nephrologist to withhold the information that he is a match for the transplant. He fears that the family might resent his decision if they were aware of it.
Application of Ethical Principles in Analysis
Principlism can be applied to analyze these ethical issues. The four principles offer guidance in evaluating the ethical aspects of the case. Autonomy is relevant as it involves respecting the father’s decision-making capacity and right to determine what happens to his body (Bioethics on Demand, 2020).
Beneficence comes into play as the medical team considers the potential benefits of a kidney transplant for the girl’s health and well-being. Non-maleficence ensures that the potential risks and harms of the transplant procedure are minimized (Bioethics on Demand, 2020). Justice becomes concerned regarding the fair allocation of medical resources and equitable treatment among potential donors (Bioethics on Demand, 2020).
Conflicts Among Ethical Principles
However, conflicts between these principles arise in this case. Autonomy dictates that the father has the right to decide about his body. Nevertheless, beneficence suggests that the transplant could significantly benefit the daughter’s health. The conflict arises when the father’s decision not to donate the kidney may harm the girl’s prognosis. Truth-telling and honesty are also challenged when the father requests the nephrologist to lie to the family about his match, highlighting the tension between autonomy and veracity.
Conclusion
In conclusion, the ethical concerns in this case revolve around the father’s choice to decline kidney donation and his request that the nephrologist conceal this information from the family. Principlism provides a framework for analyzing these issues with several guiding principles. However, conflicts between these principles emerge, primarily regarding the father’s autonomy versus the potential benefits for the daughter’s health. The request for dishonesty also challenges the principle of truth-telling. These ethical complexities illustrate the need for careful consideration and dialogue among the medical team, the father, and the family to reach an ethically sound resolution.
Reference
Bioethics on Demand. (2020). Principlism: Four principles to rule them all? [Video]. YouTube. Web.