Author(s): Francesca Donno, Davide Ferorelli, Serena Corradi, Maricla Marrone, Biagio Solarino & Alessandro Dell Erba
In the Italian national context the promulgation, on December 22nd 2017, of Law n. 219, states the overcoming of Hippocratic ethical-deontological tradition; the patient’s conscious and freely expressed will concern its health condition becomes the nodal point of the lawfulness of the medical-surgical treatment. Transpose this innovative forensic matter in the field of transplant medicine is an essential operation. Authors conduct a critical analysis according to traditional criteria of the “triptych” legal medicine/ethics/law of a case evaluated by the Apulian Regional Transplantation Centre, developing general considerations valid for others health systems too. The case refers to siblings. The receiver, a 53 man, suffers from chronic renal failure under dialysis for three years; and the potential donor, his sister of 51, is affected by thalassemia trait and, as Jehovah's Witness, rejects blood transfusions. This case represents a paradigmatic example of the latent conflict between the right of the individual and the community interest: the patient/receiver versus the donor/bearer rights. Seems important to consider also the general frame in which the case has developed: the Italian public health national service, with its needs, its workers’ rights and duties and its economic limits. The questions are: Who comes first between patient, donor and health system? Which criterion and scientific method should be used to harmonize the whole system? The transplant community will have to reformulate the method, criteria, organization and routine procedure through a deep meditation about ethical-deontological assumptions and “new” legislation.