Medical Ethics

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NAME: Shengxiang Guo
ID: 0465971
Date: May 9th 2013
Title: Disclose of Non-paternity

Introductions
Here is an interesting case based on a case happened in real life, and I will use this case to discuss the issue of disclosure of the non-paternity relationship. Miss D, an 18 years old woman, went to the transplant center claiming that she’d like to donate her kidney to her father. She seems highly motivated about the donation and her kidney is healthy, and medically suitable for donation. Mr. D, who is the father of miss D and the recipient in this case, is a 50 years old man who has kidney disease. It has been proved by doctor that transplantation is the only way to treat his end-stage kidney disease. After HLA testing, the result shows that Miss D and Mr D cannot be genetically related and the result is confirmed by repeated tests. There is no indication that Miss D and Mr D think they are not genetically related. (Real case published in the journal Seminars in Dialysis in 20021) To answer the initial questions of this case, the main issue is whether the transplantation team should disclose the truth about non-paternity to Miss D and Mr D. The relevant agents are transplantation team, Miss D the donor, and Mr D the recipient. In present point, it is time for transplantation team to acting, which is whether to disclose the truth to the donor and the recipient. Then, Miss D and Mr D will be affected because of the decision made by transplantation team. The consequences are depending on the action of transplantation team. The worst thing could happen might be Miss D changed her mind after knowing the truth of non-paternity and declined to donate her kidney anymore, and that will largely eliminate the benefits of Mr D. The fundamental rights and obligations include ‘no duty to disclose’, ‘Beneficence and nonmaleficence’, etc. The social role related duties involved in this case is parent-child relationship. Next, before we apply ethic theories to this case, lets clarify the advantages and disadvantages about disclose non-paternity. The possible advantages of disclosure are: 1. Miss D might be happy that she doesn’t have kidney diseases in her genes, and she will not pass on the condition to her kids. 2. Miss D’s right to know ones real parents is being respected. 3. The patients may appreciate the honesty of the transplantation team. Etc. The possible disadvantages of disclosure are: 1.The patients might become emotionally distressed by the news. 2. Miss D might refuse to donate her kidney to Mr D anymore, which may resulting Mr D’s death. 3. The presumed father Mr D might refuse to accept the kidney, which will also resulting his death. 4.The relationship between the family members will be damaged and the happiness of each family member involved will be significantly reduced. In following section, I will apply three basic ethical theories to this case, and discuss based on each theory what would most likely be the action of transplantation team. Kant’s Ethics

Kantian believe that ‘we should always act so as to treat humanity, either yourself or others, always as an end and never as only a means.’(Basic moral theories 2) This means, we have to treat every rational being as an end. In this case, it is clearly wrong to cover the truth just so that Miss D will donate her kidney, because if transplantation team covers the truth, they are treating Miss D as a means that can donate the kidney to Mr D. In order to treat Miss D as an end, what transplantation team should do is to tell the truth about non-paternity to Miss D, and let her to make decision about donate kidney or not. Kantian also believe an action is right when it satisfies the Categorical Imperative. In another words, ‘Whenever I am in circumstances like these, I will…’ Therefore, if we stand on Miss P’s position, most likely, we will hope to know the truth about our paternity issue. As we prove the universalizability of this maxim, disclose the truth about...
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