Mrs. Z

           Mrs. Z, a young, pregnant woman with no children underwent an ultrasound examination. Her baby girl was overdue and he ultrasound revealed that she was anecephalic. There appeared to be no brain tissues present except for portions of the brain stem. The parents were told of this tragic diagnosis and immediately decided to volunteer the baby as an organ donor. The obstetrician in charge of Mrs. Z’s care decided to contact a large, tertiary care facility nearby in order to ascertain their interest in utilizing the child as a donor.

            Two-thirds of children who suffer from anecephaly are stillborn. Many of the organ systems in such children are underdeveloped, but it is possible to utilize both the heart and kidneys for transplantation to other children. The OB and the pediatrician agreed that it would soon be necessary to induce labor. However, if organ procurement was to be undertaken, it seemed reasonable to transfer her to the large tertiary care hospital to induce labor there.

            The rest of the medical staff was uncertain to proceed. If they accepted the mother’s wish to have the baby be an organ donor, were they under an obligation to try to resuscitate the infant if it was stillborn? What steps should they take to try and support the child considering that babies born with this condition normally receive no aggressive treatment in the neonatal nursery? Perhaps most confusing was the question of when death should and could be pronounced.

            Should Mrs. Z be transferred to the large medical center? Should the physicians accept the wishes of Mr. and Mrs. Z to have their child serve as an organ donor? If they do, what steps would be morally permissible to help increase the chances of allowing the child to serve as an organ donor?

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--> -->Crigger, Bette-Jane. Cases in Bioethics : Selections from the Hastings Center Report. 3rd ed. New York: St. Martin's Press, 1998.