The delay of a kidney transplant for a 2-year-old Georgia boy because of his father’s probation violation sparks a debate on organ transplant guidelines.
A.J. Dickerson was born without kidneys.
The 2-year-old boy’s father, Anthony Dickerson, is a perfect match and a willing organ donor.
However, doctors at Emory University Hospital in Georgia have halted the planned procedure.
Because Anthony Dickerson violated his probation.
Now, A.J.’s surgery, initially planned for early October, is not slated to be performed until January.
The family is frustrated and scared.
They and many others are questioning why something as petty as a probation violation is affecting a life-saving operation for a child.
Police arrested Dickerson in September for attempting to elude police and possession of a firearm or knife during the commission of attempted felonies, the Atlanta Journal-Constitution reported.
The charges also amounted to a parole violation because of Dickerson’s previous criminal record. Dickerson has been in and out of jail in Gwinnett County since 2011.
Emory and the jail made special provisions to allow Dickerson to be escorted to the hospital for presurgery blood work and appointments on September 29.
Dickerson was released from jail on October 2, still allowing him to take part in his son’s surgery, which was planned for the following day, on October 3.
After he was freed, however, his family received news from Emory Hospital that they would no longer perform the surgery on that day, instead pushing the date back by months.
Since the delay of the procedure, A.J. was hospitalized for peritonitis, an abdominal infection on October 29. He remained there for treatment for more than a week.
During that time, the young boy battled pneumonia and surgeons implanted a new port in his body for dialysis and blood transfusions.
A.J. returned to his home last week, where he is regaining his strength in preparation for his kidney transplant.
That A.J.’s health, indeed his very life, was compromised over a probation violation has made the Dickerson case a national story.
“It’s about my son,” Carmellia Burgess, A.J.’s mother told local station WXIA. “He’s been through a lot. It’s like we’ve been waiting on this. And Dad making a mistake shouldn’t affect what he wants to do with our son.”
One expert described the delay of the boy’s surgery as “befuddling.”
Michael H. Shapiro, a professor of law and an expert in bioethics and organ transplantation at the University of Southern California (USC), shared that sentiment.
“This donation is to a family member, which is generally allowed by most states. [It’s] not clear where Emory University Hospital, and possibly the Georgia prison system, are coming from,” he told Healthline.
Organ donation by prisoners is a slippery issue in the United States.
It presents additional risks and ethical dilemmas. But those tend to only exist when the prisoner is actually incarcerated.
The most fundamental risk presented by prisoners is a health risk.
Prisoners are considered a high risk group because of higher rates of blood-borne infections, including HIV and hepatitis, than the general population.
This places recipients at increased risk of contracting these illnesses.
Medical ethicists have also argued against organ donation by prisoners because it may be considered coercive.
According to transplant guidelines set forth by the United Network for Organ Sharing (UNOS), donors must give “informed consent” for organ donations — which some have argued is not possible within the penal system.
For a transplant team, these additional risks must be evaluated not only for the safety of the recipient, but the donor as well.
The difference in this case is that A.J.’s father was free at the time of his son’s procedure. He wasn’t behind bars.
UNOS guidelines require that donors meet a strict set of qualifications, including those intended to keep them safe and healthy after the procedure.
“Since some donor health conditions could harm a transplant recipient, it is important that you share all information about your physical and mental health. You must be fully informed of the known risks involved with donating and complete a full medical and psychosocial evaluation,” the guidelines state.
According to ABC News, the transplant team may have been worried about Dickerson’s future ability to follow through on his own postoperative care due to his recent arrest.
“Removal of a kidney is major surgery. Recovery for a living donor entails consistent follow-up visits with the transplant team for approximately two years following surgery to ensure proper function of the remaining kidney and to avoid future health problems,” Emory Hospital said in a statement.
Representatives from both UNOS and the Health Resources and Services Administration both declined to comment to Healthline on the specifics of this case.
“UNOS is not involved in any individual evaluation or acceptance of a patient or a living donor. Those are individual medical decisions made by the transplant team,” one said.
But, donations between parents and children represent a special situation, argued Shapiro.
“If [the father’s] health is not good, he should be able to take personal risks to save his son,” he said.
Shapiro emphasizes that with any medical treatment there is a risk versus rewards scenario.
In a case like this, even if the father presents a greater risk to himself, Shapiro said he should be able to make an informed decision to assume that risk for the sake of his child.
The hospital still stands by their decision and the rescheduling of A.J.’s procedure. They insist that Dickerson show “evidence of compliance from his parole officer for the next three months.”
Currently an online petition started on behalf of the child and his family for the hospital to approve and perform the kidney transplant as soon as possible has more than 130,000 signatures.
“Risks and benefits are rarely all-or-nothing. In this case, the fear of tainted assent or other risk is absurd. This is a father and his son,” said Shapiro.