Abstract
John is a 30-year-old man suffering from severe mental handicap (IQ:30) and epilepsy, without other physical deformities or illness. He is sociable, would initiate social interaction (physical), enjoys a cuddle and going out on trips. He has no communication skills but is able to understand basic commands like ‘open your mouth’, ‘sit down’ and so on. He has been a long-term in-patient in a mental handicap hospital for the past 15 years. He is from an affluent family and had been admitted because of his family's inability to cope. He has visits from his mother once a month, and from his father less frequently. A few months ago his mother left a verbal instruction to the ward staff to make arrangements to donate his organs and to ask me, as responsible medical officer, to leave written instructions to inform the local Organ Transplant Team before his death, whenever it becomes imminent, so that the Organ Transplant Team can remove the necessary organs on his death.
Highlights
What is the need at tshtiitsutsetdagjeu,dgwehmeennth?eHisasaJliovhen'asndmowtheellr, gfoort atnhyisosthuebr interest to make this request? Substituted judgements are usually used to benefit the individual concerned or to benefit a known close relative; for example, donation of bone marrow to a relative by an incom petent person or the donation of a kidney to a relative by an incompetent person when no other compatible donor could be found
The other aspect of this case is whether John is different from the others, and is his mental handicap making him less of a person - a non-autonomous person? Because of the involvement of moral philo sophers and the Human Rights Organisation, the concept of autonomy has become extremely import ant in the health care profession
The con cept of autonomy has been given such importance in rSetcueanrtt yMeialrls,wrthoitse whiassetshseayporinnc'iLpilbeerotyn'. w"hTichhe Joonhlny purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others
Summary
Others refuse to donate organs because they do not wish their bodies to be mutilated after death. We are prepared to mutilate their bodies to donate organs for the benefit of others when their wishes are not known.
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