Ethical dilemmas often arise in the medical field, and they necessitate the application of bioethical principles. The bioethical dilemma in this case is whether Jason, who has intellectual and developmental disabilities, should be allowed to donate a kidney to his elder brother, Terrence. There are potential risks and benefits for both Jason and Terrence if Jason donates the kidney. It is important to consider how each person would be affected by the decision made. The situation can be assessed by applying philosophical ethical theories and bioethical principles. From the bioethical principles of beneficence and nonmaleficence and the philosophical paradigms of utilitarianism and virtue ethics, Jason should be allowed to donate a kidney to save Terrence’s life.
Beneficence and Nonmaleficence
Jason should be allowed to donate a kidney to his brother because it is the ethical thing to do from relevant bioethical principles, such as beneficence and nonmaleficence. The principle of beneficence holds that medical professionals should always act for the benefit and welfare of their patients (Vaughn, 2019). Nonmaleficence means that healthcare providers should avoid actions that bring harm to patients or simply to “do no harm” (Vaughn, 2019). Allowing Jason to donate a kidney to Terrence is in accordance with the principle of beneficence. Jason’s psychiatrist believes that Terrence’s death would be traumatic to Jason.
Additionally, Jason views his brother as a role model, so his improvement is dependent on Terrence. Therefore, undertaking an action which saves Terrence’s life is beneficial to Jason and is the ethical thing to do from a beneficence perspective. It is also the ethical choice from a nonmaleficence viewpoint. If Jason is not allowed to donate the kidney, Terrence could die as he awaits other organ-donor options. This would negatively impact Jason’s psychological wellbeing, which would be against nonmaleficence. Therefore, Jason should be allowed to donate a kidney to save his brother’s life.
Aside from considering bioethical principles, the given case can also be analyzed by evaluating relevant philosophical paradigms. From a utilitarian standpoint, Jason should be allowed to donate one of his kidneys. Utilitarianism is an ethical theory which suggests that actions are moral if the maximize the welfare of all the involved individuals (Vaughn, 2019). Additionally, utilitarianism advocates for actions that bring happiness or pleasure and opposes those that cause unhappiness (Vaughn, 2019). If Jason donates a kidney to Terrence, Terrence would continue to live, which would make Jason happy.
On the other hand, if Jason is not allowed to donate his kidney and Terrence dies awaiting a compatible cadaver or live donor, Jason would be extremely unhappy. In addition, the donation would keep Terrence alive, which means that this is the action that would bring him pleasure. Mr. and Mrs. R. would also be happy to see Terrence alive and Jason performing well in school and at the hospital. This can be achieved by allowing the kidney donation from Jason to Terrence to happen. Thus, allowing Jason to donate a kidney to Terrence is the action that would maximize good and bring happiness to everyone happiness in this situation.
Another ethical theory that is applicable to the given case is virtue ethics. This theory advocates for actions that promote virtues such as honesty, integrity, prudence, kindness, and self-control (Vaughn, 2019). Under this ethical theory, a person is considered moral if they live virtuously and undertake actions that are in accordance with these virtues. From the philosophical perspective of virtue ethics, Jason should be allowed to donate his kidney to his brother. Donating an organ to a person in need is an act of compassion. It is also a charitable act that requires courage because the procedure involves certain risks, including death. Nonetheless, donating a kidney is a brave and kind act that the virtue ethics theory would commend.
Some people may argue that allowing Jason to donate a kidney to Terrence would be against the bioethical principles of autonomy and informed consent. In bioethics, autonomy means that a person has the absolute right to make decisions about their treatment (Vaughn, 2019). They have the right to decide which treatments to undergo and which ones to refuse. The principle of autonomy is closely related to informed consent (Vaughn, 2019).
Informed consent means that a patient should be provided with all the relevant information needed to make a decision. They can only consent to a treatment if they are fully aware of the implications of that decisions. Some people may say that Jason cannot make medical decisions because his I.Q. corresponds to the mental age of a child, and children cannot consent to medical treatments. They would also argue that Jason’s speech defect implies that he does not have the capacity to understand the implications of donating a kidney, which means that he cannot give informed consent.
While it is true that Jason has a low mental age and diminished communication abilities, he can still make decisions autonomously and give informed consent. All adults are assumed to have the capacity to make medical decisions unless otherwise proven (Vaughn, 2019). It would be unethical to assume that Jason cannot make such decisions because of his impairment. Instead, it would be more prudent to evaluate his capacity to do so (Sullivan & Heng, 2018). To have capacity to consent, a person must fully understand the proposed medical treatment. They must also be able to retain the information for long enough to process it and arrive at a decision (Sullivan & Heng, 2018).
Finally, they should be able to communicate the decision to their medical provider. Although Jason has speech defects, he can still understand, retain, and process information and then communicate his decision. Since he can converse with those well-acquainted with him, his parents and psychiatrist will be crucial in explaining to him the medical decision and implications of donating his kidney. Thus, Jason can act autonomously because he has the capacity to make an informed decision.
In conclusion, Jason should be allowed to donate his kidney to Terrence. This decision would be according to the utilitarianism philosophical theory because it maximizes good. Allowing Jason to donate his kidney to Terrence would make everyone happy, which is the most important thing according to the utilitarian theory. The decision would also align with the virtue ethics paradigm since it is a compassionate, brave, and selfless act. From a bioethics perspective, Jason has the right to autonomy, which means only he can decide how to proceed. He should be allowed to independently donate or refuse to donate his kidney to Terrence. His parents and the medical personnel responsible for him should not treat him like a child because although he has speech defects, he can still communicate adequately to people close to him. Jason has the capacity to autonomously decide whether or not to donate a kidney to his brother and should be allowed to donate it.
Sullivan, W. F., & Heng, J. (2018). Supporting adults with intellectual and developmental disabilities to participate in health care decision making. Canadian Family Physician, 64(Suppl 2), S32-S36.
Vaughn, L. (2019). Bioethics: Principles, issues, and cases (4th ed.). Oxford University Press.