Oh, NO! ANOTHER Ethics Story That I Don’t Understand At All! EVERYTHING IS SEEMINGLY SPINNING OUT OF CONTROL!

Emory University Hospital in Georgia had scheduled kidney transplant surgery for a 2-year-old boy to take place on October 3. The organ donor, however, the boy’s father, Anthony Dickerson, violated his parole. Hospital administrators then postponed the surgery until Dickerson could comply with parole requirements for an additional three months.

The boy’s mother, Carmella Burgess, received a letter from the hospital that said Dickerson would be re-evaluated as a donor in January after it receives documentation of his success.

What warped reasoning is going into this decision? The boy’s health care needs are the same. The kidney being donated is the same. The father is still a willing donor. Why would the hospital care whether Dickerson had violated parole or not? Why would anything Dickerson did change the hospital’s medical duty to his son, or warrant postponing life and death surgery? So the father was discovered eating puppies. So he was found to be a convert to Isis. So he is caught saying nice things about Harvey Weinstein, Donald Trump or Satan. In fact, Dickerson violated parole in September and was charged with possession of a gun. So what?

“They’re making this about dad,” Burgess told the Atlanta Journal-Constitution. “It’s not about dad. It’s about our son.”

That seems to be an accurate analysis.

If anyone can explain how this can possibly be ethical conduct by the hospital, please do.

28 Comments

Filed under Bioethics, Childhood and children, Ethics Alarms Award Nominee, Ethics Dunces, Health and Medicine, Kaboom!, Law & Law Enforcement, Professions

28 responses to “Oh, NO! ANOTHER Ethics Story That I Don’t Understand At All! EVERYTHING IS SEEMINGLY SPINNING OUT OF CONTROL!

  1. Neil Dorr

    Jack,

    FRIENDLY CORRECTION:

    “… to take place on October 3 …”

    Then they’d better call Doc Brown on Mr. Peabody, because they’re running a little behind.

      • Neil Dorr

        I re-read it. They still missed the scheduled date.

        • Right. And the article says its been rescheduled for January. It was postponed before the third. See:

          The hospital “had scheduled kidney transplant surgery for a 2-year-old boy to take place on October 3. The organ donor, however, the boy’s father, Anthony Dickerson, violated his parole. [That is BEFORE that date] Hospital administrators then postponed the surgery until Dickerson could comply with parole requirements for an additional three months.

          That’s November, December, January. No DeLorean needed.

          • Neil Dorr

            I realized my mistake after you re-read it. So I correct myself that they still missed the scheduled date. Sorry, I thought you would pick up that I was being a smartass.

  2. In a discussion many years ago, did you not say that the criminal sentenced to death had forfeit his rights to donate his organs?

    https://ethicsalarms.com/2013/11/27/comment-of-the-day-ethics-quiz-the-kidneys-of-orlac/

    Or is the difference here the death sentence. That the death sentence in the former case still cuts off all function in society even organ donor ship and that presumptively the father in this latter case is not under penalty of death he still gets to donate organs?

    • You have a good memory. I also forgot that you issued a Comment of the Day on the topic.

      1. Parole isn’t a death sentence. The condemned have no rights to do anything.
      2. In the current case, the father was already the approved donor. In the other, there was no evidence that the recipients didn’t have other options.
      3. As I mentioned, there was reason to doubt that the condemned prisoner was stalling.
      4. Parole means the father is free, which is far from Death Row.
      5. This case was the start of my gradual conclusion that John Kasich was a hopeless weenie.

      • I have phenomenal long term memory. Ask me about a conversation yesterday or someone I met two days ago… I’ll have no clue.

        Ask me about the same conversation or person 6 months or longer from now, and I’ll remember it with clarity and exactitude.

        A bit hyperbolic self-description, but more accurate than not.

        It’s a burden sometimes, especially in these discussions because I remember precisely where someone will say something in complete contradiction or seeming contradiction to something they concluded before, and I feel duty bound to seek out the exact quote I recall to make sure I haven’t forgotten. Those searches are sometimes very time consuming.

  3. Bethia

    I think, as usual, they are worried about lawsuits afterwards, if either/both die or have complications. Donors need to be healthy, recovery can be long and difficult for both parties to the transaction. If this donor has been using drugs, (just taking a wild guess here, no proof)…. as is unfortunately common with felons, his overall health and of course the organ may be compromised…making the surgery and then post-surgery more complicated…and then, he or his heirs are going to sue, another twisted version, alas, of the ghetto lottery! The hospital has rules about healthy donors for very good reasons, they do not want to pay out millions.

  4. One of the questions always asked by the United Blood Services is whether one had been in prison within the last 12 months. I think the risk of contracting something…virulent…in prison is considered high enough that incarceration raises serious flags. After all, it wouldn’t make much sense to give someone in desperate need of blood HIV or Hepatitis along with the transfusion.

    As always, I reserve the right to be WAY off base, but it could be the same scenario here. Parole violation often entails incarceration. Incarceration could lead to contracting unsavory diseases. It may be that three months clean of any parole violations corresponds to the minimum possible time for anything terrible in the father’s system to become detectable. This might actually be a reasonable precaution that is only looking toward the child’s well-being.

    • Interesting. But since he wasn’t going back into jail by October 3, why would this matter?

      • I’m still not clear on all the details of the case, but Mr. Dickerson was held in jail for a few days prior to a pre-operation procedure. I don’t recall if the consideration for incarceration is for prison only, or if it includes holding a local jail cell, as well. If the latter, then the hospital might be suggesting that three months without parole violations is their best guess that he’s keeping himself clean, out of jail, and is the minimum possible time they would allow for anything…communicable…to show up in his system.

        But… this is a wild-ass guess, nothing more. This could very well be the hospital playing vigilante against a hardened criminal.

  5. John E. Staszak

    From what I understand, transplant protocols disallow organs from donors who have been recently incarcerated because prisons are festering pools of disease, at least according to reddit.

    It sounds to me like Dad is the one at fault for his son having to wait for the operation.

    • It’s not the hospital’s job to find “fault,” it’s a medical professional’s job to avoid harm to the patient. If the parole breach was in September and the surgery in early October, and the violation wasn’t for drugs, somebody is being unduly technical at the risk of a child’s life. In the earlier case discussed here about a condemned prisoner in Ohio who wanted to donate organs, that supposed restriction on prisoners wasn’t raised as an issue at all. In the absence of any indication or test that showed contamination, I see no reason why a waiver and consent from the family wouldn’t suffice.

      • John E. Staszak

        I don’t think the hospital was finding fault, I was. I think it’s possible they delayed the procedure because the father’s actions, being arrested and spending time in jail, violated their transplant protocols. I don’t know enough about organ transplants to be able to advance a meaningful opinion on whether the delay is unfeeling bureaucratic adherence to the rules or a reasoned judgement that maintaining the little boy on dialysis until it can be determined whether or not his father was exposed to any diseases during his time in jail is the safest course, but, presumably, his doctors are.

        Regarding the previous about the prisoner, it doesn’t surprise me that this issue wasn’t raised because the reporter from the linked article didn’t address it in any way. Her story was six short paragraphs that was pretty short on details.

  6. Rusty Rebar

    I’m just spit-balling here. Is it possible that what he did to violate his parole might have had an impact on his stability? For example, if the parole violation was drug use, and drug use disqualifies an organ donor, that might explain it. He would need to show that he is 90 days clean to meet the donor requirements. The hospital would also be prevented from announcing this due to HIIPA requirements.

    • Rusty Rebar

      Not sure how stability got in there. It should say “Is it possible that what he did to violate his parole might have had an impact on his ability to be a donor?”

  7. They have to reevaluate to make sure he hasn’t obtained some disease in the mean time.

  8. A.M. Golden

    This is a situation where I would totally accept “Won’t someone please think of the children??”

  9. Ash

    via reddit

    Toddler denied kidney transplant from 100% match dad because of probation violation

    For people wondering why the hospital made this decision, inmates can’t donate blood or organs because of potential risk of exposure to diseases in prison.
    Here is a statement from the Red Cross on blood donations:
    “Persons who have been detained or incarcerated in a facility (juvenile detention, lockup, jail, or prison) for more than 72 consecutive hours (3 days) cannot donate blood for 12 months from the date of last occurrence. This includes work release programs and weekend incarceration. These persons are at higher risk for exposure to infectious diseases. Guidelines on eligibility to give blood change from time to time. The most up-to-date eligibility information can be obtained by contacting the American Red Cross blood center nearest you.”

    and

    > Its not marginal at all. In order to avoid a rejection they nuke the immune system of the recipient. That means any disease, any at all, that would normally be fought off, won’t be. So if the dad was exposed to say, tuberculosis (which generally is only a problem for immunocompromised people and is like tetanus in that it is everywhere), and he gives it to his kid straight from jail, the kid will immediately get tuberculosis and die. It might even happen with the common cold, because the kid just has no immune system at all at the time of and immediately after, the transplant.

    Edit: To the repeated question: Diseases take time to incubate and for an effective test, they wait for three months after having been in high risk areas (like jails). Red Cross waits four times as long, per the top comment. Wouldn’t do for a dormant infection that doesn’t affect a healthy person to cross into an immunosuppressed child. Even the common cold could kill him. Since the child can survive just fine on dialysis for a few months, they’re taking the safest route for the child. In no way is the hospital punishing anyone. They’re doing what is medically the best thing. And I’m done with this thread.

    and

    I work in organ donation. If this were an adult that could consent for themselves to taking a high risk organ, it would happen. This is a child. Doctors want to put children in as little risk as possible and donors who have recently been incarcerated for 72+ hours are higher risk. This kid has good doctors making good decisions

    and

    How the fuck does a toddler get on probation?

    • As I said: the parents can consent.
      Moreover, if the hospital’s letter didn’t talk about the short period in jail rather than “breaking parole,” there wouldn’t be a story. if the possibility of infection is the problem, why doesn’t the hospital say so, rather than having the mother, the ANA, Ethics Alarms and the news media thinking it is about a parole violation?

      The explanations raise more questions than they answer.

  10. Still Spartan

    Is it possible that there is a more cynical answer? People who violate parole often go to prison. People in prison have health care provided by the State. Who would pay for his side of the operation? What about his medical recovery? That also would be have to be on the State’s dime if he is in prison. Perhaps he has to wait these additional months so the State can cross him off their list.

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