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, .
Tex is a wealthy oil tycoon in need of a liver transplant. Since the waiting list for livers is long, he decides to take matters into his own hands. He places billboards all over his state that read, "Tex needs a liver. Please help!" He advertises on both radio and television, asking anyone with a loved one who is in a fatal accident to earmark the victim's liver to go specifically to him. In the ads, Tex touts himself as a model citizen, a veteran, a churchgoer, and a patron of the arts.
Soon after the billboards go up, the wife of an unconscious patient on life support announces that she will donate her husband's organs only if the liver goes to Tex. In Tex's state, hospitals generally will not authorize transplants unless the patient has given written instructions in advance or the patient's nearest relative consents.
See the results and what an ethics expert has to say.
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:
Spill Patient's Medical Secrets to SEC?