Case studies in transplant ethics

Clinicians and other health care professionals involved in the evaluation and management of organ transplant recipients and organ donors quite commonly encounter ethically complex scenarios during the course of their work. The response to such challenging situations may be influenced by personal experiences and beliefs, programmatic or institutional policy, existing legislation, published literature, and consultative analysis by experts in the field of biomedical ethics. As organ transplantation continues to evolve in its scope, complexity, and global reach, there is a growing need for transplant programs to carefully discuss and reach consensus on how to deal with specific ethical issues that may arise. In this article, we present the summaries of 3 clinically relevant case scenarios from the 2007 Mayo Clinic Course in Transplant Ethics, along with the results of audience responses and discussion facilitated by a volunteer panel of experts from North America.¹1Expert panel: (1) Michael P. Bannon, MD, Consultant, Trauma, Critical Care and General Surgery, Mayo Clinic; Chairman of the Transplant Center Ethics Advisory Board. (2) Sheila Jowsey, MD, Consultant, Department of Psychiatry and Transplant Center, Mayo Clinic. (3) Charles Miller, MD, Director, Liver Transplant Program, The Cleveland Clinic. (4) Kathy Schwab, RN, Supervisor, Transplant Coordinators, Transplant Center, Mayo Clinic. (5) Robyn Shapiro, JD, Director, Center for the Study of Bioethics, Medical College of Wisconsin. (6) Maryam Valapour, MD, Consultant, Center for Bioethics, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Minnesota Medical School. (7) Linda Wright, MHSC, MSW, RSW, Consultant Bioethicist, Toronto General Hospital/University of Toronto. The cases provide cogent examples of how open, consensus-driven discussion of specific ethically charged scenarios can be useful in guiding progressive clinical practices in organ transplantation.