Doctor Donates Kidney to Her Patient/ Ethics Examined

Chicago Doctor Donates Kidney to Patient
By DEANNA BELLANDI
Associated Press Writer

April 25, 2003, 8:43 AM EDT

CHICAGO -- The case of a doctor who donated a kidney to one of her patients is raising new ethical questions about the doctor-patient relationship and organ donation.

For Dr. Susan Hou, donating a kidney was something she had thought about since her days in medical school where she had a friend with kidney disease.

"I can't bring about world peace, I can't eliminate world hunger, but I can get one person off dialysis," said Hou, 56, medical director of the renal transplant program at Loyola University Medical Center in suburban Chicago.

But medical ethicists, who say they know of no similar case in the United States, believe such a gift complicates the relationship between doctors and patients, and raises the issue of how a doctor decides which patient gets their life-saving gift.

The person Hou chose to help was a 34-year-old suburban mother who was referred to Loyola's transplant program.

Hou said other people haven't been a match for her kidney and something just clicked when she met Hermelinda Gutierrez, who was suffering from polycystic kidney disease.

"Just because you can't give to everybody doesn't seem a reason not to give it to anybody," Hou said of her decision.

Loyola has 421 patients on a waiting list for a new kidney and the United Network for Organ Sharing said there are more than 54,000 people in the country waiting for kidney transplants.

At Loyola, Hou is part of the team that has cared for Gutierrez since her transplant in October.

That Hou cares for Gutierrez may be problematic, said ethicist Arthur Caplan of the University of Pennsylvania.

"It's bad when doctors care for family members; it's probably a bad idea for them to take care of people who are carrying around one of their organs," Caplan said.

Hou said she thought about not seeing Gutierrez as a patient anymore, but that didn't seem right.

"It would be really artificial not to see her and to avoid her," Hou said.

Dr. David Hatch, who also is on Loyola's transplant team, said because a team -- and not just Hou -- cares for Gutierrez some of the potential conflicts ethicists might raise are lessened.

If other transplant professionals want to donate organs, it might be better if they go to a transplant center other than their own, said Dr. Mark Fox, chairman of the organ sharing network's ethics committee.

That way, physicians can avoid potentially conflicted relationships with colleagues and patients, Fox said.

"I think this will generate some discussion and I would suspect that more people, physicians and nurses, probably will step forward to be living donors," Fox said.

Gutierrez said she couldn't believe it when Hou made the offer to be her organ donor: "People like this exist. But I didn't know I was going to meet one."

The patient said she suffered severe headaches and high blood pressure before the transplant, and her family was gravely worried.

"Now they are very happy," she said. "They see how much better I'm feeling -- what a big difference it has made in my life, for all of us."
Copyright © 2003, The Associated Press