You are a doctor in a hospital with a patient who is also a close friend. The patient is currently unconscious and suffering from acute kidney failure. You have tried multiple times to get a hold of this person’s family but have not been able to. You are also unable to find a will for the patient. This friend is very passionate about her religion, which, amongst other things, doesn’t allow its people to use lab-made organs. Your patient came into the hospital very late, meaning actions must be taken immediately if you plan to save her.
Unfortunately, your friend is in urgent need of a new kidney, and because of your location, all you have access to are lab-grown organs. You have the choice of giving her a lab-grown kidney, meaning almost certain survival, but this would require betraying your friend’s trust. If your friend were to find out, she would feel absolutely betrayed and you could lose an important companion. Additionally, if the church discovered that she had a lab-grown kidney inside her, she would be kicked from the church forever and looked down upon by all her people.
Your only other option is to leave your friend with her own kidney and hope that she heals. However, the chances of survival with this route are extremely slim. If your friend does survive after this option, she and the church will be eternally grateful and loving towards you.
What should you do?
The artificial kidneys would be made with a process that, at the time in the future that this takes place in, is very well tested and done regularly. First, engineers take cells from kidney tissue of another human with a normal and healthy kidney. These cells are isolated and the scientists are very careful not to contaminate the cells with any pathogens, other cells, or any anything else. Next, the cells are mixed with growth factors. These growth factors can include hormones and nutrients that allow the cells to divide at an efficient rate. Once there is visible growth in the amount of kidney cells, scientists will create 3D scaffolding in the shape and size of a human kidney. The growing complex of kidney cells are then placed on the scaffolding. This causes the cells to form kidney tissues in the shape of a kidney. This process is carefully monitored by scientists because any mistakes in this phase could render the entire kidney useless.
As the cells continue to divide and grow, the scaffolding slowly dissolves. In the end, all scaffolding will have dissolved, leaving us with just the newly grown kidney. The fully grown kidneys are exercised and tested by precise machines so that they can and will allow movement, expansion, and contraction in all the necessary places. After all of this, the kidneys are ready and safe to use in humans. (“The ABCs of Organ Engineering,” October 22, 2015)
If I were the doctor in this situation I would certainly give my patient a lab-grown kidney, despite the negative consequences.
From a utilitarian perspective, this is the better approach because it offers the most benefits with the least harms. To start, giving my patient the kidney would almost certainly save her life. If I didn’t give her a new kidney she would almost certainly die. The former is obviously better than the latter.
Next, I am willing to take the risk of losing this very close friend. Of course, I don’t want to lose the friend, but doing so would be much better than knowing that it was my fault she died. I wouldn’t be able to live at peace with myself if I let her die when I could have saved her. Betraying my friend’s trust would be much better than letting her die. Also, having the church be mad at me would not be too big for me. Surely, it might be tedious and frustrating to deal with, but it wouldn’t affect me too greatly.
Now, it would be difficult to see my friend abruptly lose her lifestyle with the church and all of her church companions. This is one major harm that heavily strengthens the opposition. However, all of this would be lost anyway if she died. Either way she will no longer be a part of the church or have relationships with the people, so why not pick the route that also happens to save her life.
This choice also works from a virtue/egoism approach because it goes with my values and what I strive to be. As a doctor, I have taken the role of always trying to save the lives of my patients. Not giving my patient a new kidney would strongly betray who I strive to be as a person because it would mean that, rather than trying to save this person’s life, I am letting her die. One problem with this approach is that I also strive to be an honest person, and giving her the kidney would be a betrayal of her trust. Someone on the opposing side could argue this as a strength to their choices, however, the first value is more important to me and thus outweighs the second.
Next, aside from hurting my friend’s beliefs, there is no physical harm from a lab-grown kidney. The cells inside of a lab-grown kidney are exactly the same type of cells in a normal kidney because we are just extracting cells from a kidney to be used. The cells then divide like normal cells and create a normal kidney shape. After the scaffolding dissolves there is nothing but human kidney cells. If I were to put out one lab grown kidney and one normal kidney in front of my friend while she was conscious, she would not be able to tell them apart because, in essence, they’re no different.
One of the only major problems that could occur would be that my patient’s body would not be used to the new kidney at first, thus throwing some stuff temporarily out of whack within her. However, after a very short time, her body would get used to the new kidney and would return to a homeostatic state.
Lastly, from a law standpoint, the decision I made is the mandatory one. Because of the fact that there is no documentation present stating that my patient doesn’t want lab-grown organs and because family members were not available to make the decision, it is defaulted to saving my patient’s life. Refusing to save her life by not giving her a kidney would be a blatant breaking of the law, so I must give her the kidney to avoid this.
The ABCs of Organ Engineering – WFIRM. (n.d.). Retrieved March 09, 2016, from https://www.wakehealth.edu/Research/WFIRM/Our-Story/Inside-the-Lab/Inside-the-Lab.htm