Welcome to Ethics Consult — an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true patient care case. You vote on your decision in the case and, next week, we’ll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is adapted from Appel’s 2019 book, Who Says You’re Dead? Medical & Ethical Dilemmas for the Curious & Concerned.
Harriet and Arthur have a teenage son, Gary, who suffers from leukemia and requires a bone marrow donor. Unable to find a suitable match through existing donor databases, they decide to conceive a second child through in vitro fertilization (IVF), using new technologies to make sure this second child is a potential match.
As Harriet and Arthur are already in their 40s and not prepared to raise a second child, they have arranged for the young married couple living next door to adopt the child. As part of the adoption agreement, it is understood that when the boy or girl is physically old enough to donate bone marrow, these neighbors will consent to the procedure on behalf of their adopted child.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
And check out some of our past Ethics Consult cases: