Martha Sinclair brings her husband to the hospital every week for dialysis.
George Sinclair, a 70- year old man, suffers from diabetes. He suffered a mild brain
injury some years ago and occasionally becomes confused. He can still conduct his life in
a fairly normal manner, though he usually needs help remembering where he is and
what he should be doing. Martha has taken over responsibility for her husband’s care
and acts as his decision maker. George jokes and smiles, and seems happy with his life,
interacting with friends and family regularly. He has been going to the hospital for renal
dialysis for the past six months, but the disease is progressing. Recently, the doctors had
to operate to remove one of George’s toes. They informed Martha that that without a
transplant, George might need further amputations. Martha is exhausted from the
weekly trips to and from the hospital.
Although there are no human organs currently available, there is another option.
Geneticists have been able to modify genes with the intent to grow healthy new tissue,
but have not yet been successful in human transplantation. This germ-line gene therapy
can serve as an organ donor for people with reduced risk of rejection by the recipient.
Martha’s husband is an excellent candidate for such surgery. Such transplants, however,
have not yet been performed. This would be an experimental surgery, and George
would have to be kept in isolation and closely monitored for several years after the
transplant.
The doctors have been encouraging Martha and George to be in the study.
Because George would be in isolation at the hospital, the constant trips to and from the
hospital would end. As it stands now, every trip to the hospital is like the first time for
George; he is confused and frightened.
The doctors also tell Martha that George would be doing something good for
future patients if she agrees to the experimental transplant. It may benefit George
himself, and it would certainly benefit future patients. One of George’s doctors has
assured Martha that he will personally see to it that George is comfortable during his
stay at the hospital, as he is one of the key researchers conducting this study.
Some questions to get you thinking about the case study:
Should Martha opt for the transplant for George?
Is George competent to consent? Is George’s competency an issue?
Is Martha biased based on her own circumstances?
How would the philosophers consider germ-line gene therapy?
What about the experimental nature of the treatment?
Any concerns with George being a research subject?
What about the nature of the relationship between the researcher, patient and wife?