TORONTO - The tragic case of two sick babies in Toronto's Hospital for Sick Children is raising unsettling questions about medical and journalistic ethics.
Kaylee Wallace, seemingly dying of a congenital disease and Lillian O'Connor, whose heart cannot supply her tiny body with the oxygen it needs, were linked by the possibility that the former might save the latter's life.
The saga is being played out in real time on TV networks, news websites and in the pages of newspapers, with the names of all the players attached. The very public nature of the case concerns many medical ethicists who feel a deep sense of unease as they watch it unfold.
"These are not the kinds of decisions that have to be taken in the newspapers," says Trudo Lemmens, a professor of health law and bioethics at the University of Toronto.
Typically the names of transplant patients -- any patients -- aren't revealed, though occasionally desperate parents or adults in need of a transplant will go public with a plea for a donor organ. When organs from a person who died do become available, however, the public generally would not learn the name of the donor.
But more disturbing for some in this case is the fact that the parents of little Kaylee expressed an interest in directing to whom her heart would go. That is not the way the system works.
If a living person decides he or she wants to give a kidney or a piece of their liver, they can specify to whom the organ will be given. An adult brother can give a kidney to an ailing sister. Or a parent can contribute a lobe of his or her liver for a child.
But organs from dead donors go into a pool that is administered by experts who assess who gets what and when. Those decisions are based solely on need and the chances that the transplant will take in the designated recipient, ethicists familiar with the system explain.
"Currently -- certainly in Ontario -- they don't permit directing of organs after death. Because that would mean that they're being directed to somebody who may not be the one who needs them the most," says Linda Wright, director of bioethics for the transplant program at the University Health Network in Toronto.
The system is specifically designed to rule out the possibility that factors like race, gender, socio-economic status or education level would play a role in the distribution of scarce organs, Wright and others explain.
"We're not going to say `The life of a person from this section of society is more valuable than a person from another section of society. That's why we use medical criteria," she says.
"It's going to be everyone has the same shot at it, providing they meet the requirements."
