Thank Goodness for Ethics Committees

(Blogger’s Note: Due to the sensitive nature of this case, even more details than usual have been changed.)

The patient was coming to me to sign consent to donate bone marrow. Just one problem. She’s pregnant.

Does that matter?

What if I told you that the bone marrow donor is 23 years old and is donating for her sister who has leukemia?

What if I told you that the donor is 19 and is donating for an unrelated child with severe combined immune deficiency syndrome (SCIDS)?

What if I told you that the donor is 17 and is donating for her father, who has lymphoma?

There are so many variables that play into the answer to the first question I posed: Does it matter? Certainly if she is pregnant and undergoes general anesthesia, she exposes her unborn child to a small but measurable risk. How about regional anesthesia? How about the blood loss associated with marrow donation? Bone marrow transplant for a child or young adult with certain types of leukemia can be considered standard of care. What if the transplant is experimental, rather than standard?

Although these questions may seem abstract, they are not. In fact, one of the situations above happened to me recently. It was the kind of situation that made me happy that our hospital has an ethics committee.

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