Legal and Ethical Concerns in Treating Kidney Failure(Legal and Ethical Concerns in Medicine Series): Case Study Workbook

Author: Eli A. Friedman
Published: October 2000
Publisher: Kluwer Academic Publishers
ISBN: 0792365704
Hardcover Book
Number of Pages: 210

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"Once dialysis treatment, in 1960, permitted life prolongation for some but not all patients in kidney failure, an "ethical genie" was released." "Introduction of peritoneal dialysis and kidney transplantation confounded the physician's dilemma by underscoring those left untreated. Who should be selected for uremia therapy? Should exclusion from treatment be properly relegated to administrators, physicians, or better left to a committee? Are some candidates more worthy than others? As examples: Do Presidents and Kings warrant priority in cadaver organ allocation over ordinary citizens? Are rich people more deserving than the poor? Is it ethical to choose a younger over an older patient? Can children and/or mentally incompetent persons serve as living organ donors? Is it proper to market organs under controlled circumstances?" "Eli A. Friedman, an experienced nephrology training program director, and Medical Advisor to the American Association of Kidney Patients has collected 24 difficult cases that focus on these and other vexing though common stressful issues faced by those who manage kidney patients. Using a novel approach to each case, the opinions of lawyers, nephrologists, patients, and a transplant surgeon are proffered sequentially. Friedman asks and then answers searching questions arising from the debate. The quality of information presented is positively flavored by the fact that three of the respondents (one an attorney) are kidney transplant recipients." "Members of the kidney team, those emersed in seeking truth in medical ethics, and all participating in exploring the legality or ethical basis of organ replacement will find this book pertinent to their effort."--BOOK JACKET.

Table of Contents
List of Contributors
Preface
Foreword: John Bower, Brown versus Bower - The Rest of the Story 1
How to Use this Workbook 4
Kidney Donation by Children and the Mentally Handicapped: Evolution of precedent 7
Case 1 Withdrawal from Dialytic Therapy 17
Case 2 Failure to Understand Dialytic Therapy 30
Case 3 Disruptive Patient 42
Case 4 Active Heroin Abuse 51
Case 5 No Dialysis for AIDS Nephropathy 60
Case 6 Futile Dialysis 71
Case 7 Physician Bias 79
Case 8 Self Referral of Dialysis Patients 85
Case 9 Game Playing Families 92
Case 10 Physician Refusal of HIV+ Patients 97
Case 11 Religious Control of Patient 104
Case 12 Emotionally Related Organ Donation 112
Case 13 Discrimination in Organ Donation 118
Case 14 "Gift" for Transplant Priority 124
Case 15 Child to Parent Kidney 137
Case 16 Purchased Kidney 137
Case 17 Suspected Subterfuge in Proposing Kidney Donor 143
Case 18 Accepting Organ from Mentally Deficient Donor 149
Case 19 Consent from Child for Organ Donation 158
Case 20 Donor Kidney Allocation to High Risk Patient 167
Case 21 Politician's Priority for Cadaver Donor Kidneys 176
Case 22 Cadaver Donor Kidney for Non-Compliant Dialysis Patient 184
Case 23 Organ Donation/Acceptance by Orthodox Jews 192
Case 24 Hopeless Prognosis 199
Editor's Remarks 206
Editor's Epilogue 209
References 211

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