Following a rash of Hypothetical Moral Dilemmas raised in this forum lately, here’s a real life one. In short:
If I were able to talk to this mother (and as the father of twins myself), I sure as all hell have absolutely no idea what advice I could give to the poor woman 
Your thoughts?
Again - This is not a hypothetical!
Dani
Wow. That story is enough to make even Baby Jesus cry, and we all know what a tuff nut he is.
The story does not indicate that their condition is immediately life threatening. While “time is running out” there does not appear to be critical urgency. Hopefully a donor kidney will become available for one, and she can donate for the other.
If that is not the case, then she should have one removed without being told which will receive it. Truly, it should be up to the docs to determine which is most in need and which is most likely to benefit from a first transplant.
And if all else fails, let them go for a drive with a bad left rear tire. Let them figure out who’s driver and who’s passenger. Don’t forget the gun.
Flip a coin.
Yes, it’s a glib answer. But what other means is there to decide? Might as well make it fair and random.
Perhaps i’m just tired and missing something here, but they’re triplets - the boys have a sister as well, and the article says that she doesn’t have the condition.
Seeing as how they’re triplets, wouldn’t they naturally be of the same blood and tissue type? They should be for all practical purposes damn near genetically equivalent, I’d think.
So why couldn’t Mom give one and Sis another? Is there some kind of ‘minors can’t give consent’ issue here?
Not necessarily, many fraternal siblings have different blood and tissue types, and the boys couldn’t be identical to their sister (though they could be to each other).
Isn’t it possible for an adult without kidneys to survive a fairly long time on dialysis, longer than a baby could? Perhaps the mom could donate both the kidneys, and the doctors could spend their time searching for a new organ for her. They probably wouldn’t want to do this, since they’d be knowingly endangering her life, but if she herself wanted to do it I don’t think anyone should stop her.
I’d give both a kidney and go on dialysis myself. What an appalling decision to have to make.
Bravo to you!! This would be a demonstration of ultimate parental love! Who could ask more?
Thats what I thought, why can’t she donate both her kidneys and go on dialysis?
I would think so, as the infant cannot give consent and consent must be given for organ harvesting to take place.
Also, if i was a doctor, I would sudder at the surgical risk of removing any organ from an infant… in fact, there is probably no way in hell I would do so.
I don’t know about English law, but children here can and are organ donors - often bone marrow. There’s a lot of debate over parents who have a child needing a bone marrow transplant deliberately getting pregnant and having another child in hopes that the younger child can donate marrow to it’s older sibling.
I’m sure that Sinead’s tissue doesn’t match, otherwise it would be a simple solution: one kidney from mom, one kidney from Sinead. The article did say mom and the boys shared a very rare tissue type that had so far been unmatched.
I don’t think they would take two kidneys from mom. First of all, it goes far beyond the Hypocratic oath of “do no harm.” Dialysis cleans your blood, but the kidneys serve more functions than that. I don’t think it’s possible to replecate *all *functions of the kidneys artificially. People on dialysis have some limited function of at least one kidney.
I’d donate to the one whose prognosis with a transplant was best. If they are, against all odds, absolutely in the same condition with the same prognosis, I’d flip a coin. Then I’d start screaming to the press and holding tearful press conferences trying to increase organ donation in my country. And, of course, continue to take the other guy for his dialysis and hope that another match could be found. I’d probably have another baby to try and provide a match as well, controversy be damned.
What a horrible situation
:smack: of course they have to be fraternal - there can’t be identical twins of opposite sex… that’s what I get for doping so late at night.
Well, the article says that the boys are 14, so the operation probably wouldn’t be nearly so risky as you’re thinking…
From a picture of the twins in my local rag (The Israeli newspaper Maariv - sorry, couldn’t find a link to it in the free part of their online site), they may well be identical to each other - which may mean that their prognoses are nearly identical, too. (Also, they’re quite a pair of good looking kiddos… all the more horrible to contemplate, even though I know it shouldn’t make a difference.)
I wonder: Could there possibly be a donor in the mother’s family who could give the mother (but not the twins) a kidney - say a sibling of her’s? In that case, would it be feasible to do a two-stage swap - take both the mother’s kidneys for the twins, and implant this other donor’s kidney in the mother? Clearly this would put the mother in far more danger than if she were just to donate a single kidney. But it would give all three of them at least a fighting chance at a normal life. Would this even be acceptable under the hypocratic oath (maybe taking all three family members as an “entity” whose communal health must be helped to the largest extent possible, rather than looking at the mother’s status in a detached manner?)
failing this, I would have to say that my choice in her place would be, as jabiru suggested already, to donate both kidneys, go on dialysis, and hope for a donor. Or die saving them (I’m not sure it’s medically possible to live without any kidneys at all; dialysis is, IIRC, just a way of helping a faulty kidney perform part of its functions.) I cannot see myself choosing between them. Of course, I suspect it would be impossible to find a physician or hospital that would cooperate in this scheme.
Dani
here’s a different picture of the twins that I found on the 'net (from August - this isn’t exactly a new story, apparently.)
Dani
Yeah, there are cases here in the US where the parents deliberately have another child solely for the purposes of giving a transplant. I don’t know if it was a kidney transplant though, and I would imagine it wasn’t, due to the size differential.
Can’t they find a cadaver kidney?
