Prison Dad's Kidney Plea Refused by UC Ethicists / Irrevocable harm to donor, says head of panel

1999-01-16 04:00:00 PDT San Francisco -- California prison inmate David Patterson's daring offer to donate his remaining kidney to his ailing 16-year-old daughter has been turned down by a University of California ethics panel.

In a decision released late yesterday, the University of California at San Francisco Medical Center ethics committee ruled broadly that

any attempt to harvest a second kidney from a living donor "would violate well-established principles of medical ethics."

Although the panel did not specifically address the case of Oakland teenager Renada Daniel Patterson and the offer of her imprisoned father, the ruling applies to their case. The answer is: "No."

Neither Renada nor her mother, Vickie Daniel, would comment last night on the decision. The family's pastor, the Rev. Dr. Lorenzo Carlisle, said he was disappointed but not surprised.

He attributed the ruling to the fact that Renada's kidney function dramatically improved last month, eliminating the need for an immediate transplant.

"God took the thunder out of the situation and eliminated the crisis," he said. "Had there been a crisis, the decision would have had a better chance of being favorable."

Renada's case has drawn national attention on two occasions: first in 1996, when her 38-year-old father -- with whom she had little contact -- offered from his prison cell to donate a kidney to save his daughter's life.

The offer of a second kidney was made in December, when the first transplanted organ began to fail -- possibly because Renada had stopped taking the anti-rejection drugs.

Dr. Wade Smith, a UC San Francisco neurologist who headed the panel, said this issue turns on the fact that harvesting the second of two human kidneys would irrevocably harm the otherwise healthy donor.

While people can live normal lives with a single kidney, the loss of that second kidney condemns them to a life dependent on regular visits to a dialysis machine.

"Under no circumstances would one recommend going forward with such a surgery," said Smith. "For a healthy person, it would dramatically alter their life. It would increase the risk of death and shorten their life."

In fact, adults on kidney dialysis face a 20 percent chance of dying each year.

Dr. Nancy Ascher, director of the UC San Francisco Transplant Service, said the ruling "reaffirms what I think are basic principles in the field of transplants."

She said she understood the desire of parents to make sacrifices for their children but stressed that a decision to transplant organs involves donor, recipient, families and doctors alike.

"If you choose to walk through fire for your kid, that's great," she said. "But if you choose to take me with you, that's different. . . . We don't necessarily allow patients to dictate their own therapy."

The rulings of a hospital ethics committee are advisory only. An individual physician could choose to carry out a procedure in spite of the ruling. But in practice, the advice of such panels -- comprising doctors, nurses, social workers and the hospital chaplain -- is rigorously heeded. Medical ethicist John Golenski of the Berkeley-based Medical Priorities group said the decision was correct.

"Any attempt to force medical professionals to act in a way that is explicitly against the first principle of medical ethics is simply not acceptable," he said.