The other side of "No."

This was brought to my attention today.

Summary: Amelia needs a kidney. Amelia also has other medical conditions, chief among them Wolf-Hirschhorn Syndrome, a heartbreaking condition that results in mental retardation, muscle hypotonia, congenital heart defects, ongoing renal issues, and a whole host of other medical issues. A surgeon at the Children's Hospital of Philadelphia says they can't put Amelia on a transplant list because of all these issues. The family says, "that's okay, we have a big family and we're all willing to donate a kidney." The doctor still says no, it's too risky. Among the reasons the doctor cites are mental retardation. Understandably, Amelia's parents flip out and believe their child is being discriminated against.

Parent writes emotional blog post. Outrage ensues.

I ask that you please take a moment to consider this situation from the physician's point of view.

When any healthcare professional decides to enter the profession, they take an oath to do what is best for their patients, and to put the patient's health above all else.

"Then why won't they do the surgery?" you ask. That's an excellent question.

When a patient is in need of a transplant, no matter where the transplanted organ is coming from, a number of factors are considered. Among those are the long-term prognosis of the patient.

After researching her condition a bit more, as well as reading up on the specifics of the case, it seems as though Amelia has multiple health issues, including some cardiac troubles in the past. This is in addition to Wolf-Hirschhorn Syndrome.

Because of her other conditions, attempting a transplant is far more likely to result in speeding up Amelia's demise than it is to be successful. No matter who donates the kidney, that's just the reality of the situation. And then, even if a transplant occurred and was successful, how long would it be before she needed another kidney? And another? And what about her heart? Is her heart even strong enough to endure such a major procedure?

These are the things doctors have to take into consideration every day when determining whether a patient - like Amelia - is a good candidate for a transplant. You don't just show up one day needing a new organ and are put on a waiting list.

The physician arrived at his original decision not because he has it in for Amelia, or he has something against the mentally disabled. No, I'd bet that he knows that the risks involved with any sort of transplant are far too great to justify moving forward.

Now because this physician clearly has no bedside manner whatsoever (as is the case with many of the best surgeons - just ask any doctor or nurse), it came across as "we're not doing the transplant because your child is retarded." Should this have been approached by someone who is better with patients? Absolutely.

The doctor made a tough decision - one that I have no doubt was difficult for him. I'm guessing he believes it would be better for the family to have time to say goodbye, rather than send this poor child into the operating room to be sedated and probably never wake up again.

It's a heartbreaking situation for all parties involved. I understand the anger, because I've been on that end of it. But I also understand the reasoning.

In closing, I'd argue that Amelia's course of treatment should be determined in conversations between her parents and the ethics committee at CHoP. And in these conversations, both parties need to share AND listen to the other side. Although there have been several online polls established asking the hospital to perform the surgery, please remember that no matter what happens, this is not a matter for the public to decide, nor should it be.

Let's all hope for the best outcome for Amelia, regardless.