Uninformed consent, but ethical anyway?

(In response to the report regarding a mentally disabled man, Prakash, whose kidney was transplanted into his brother, Subramanyam, we asked readers to send in their responses)

Did Prakash give his informed consent for his kidney to be removed and transplanted into his brother? (1)

Actually, Prakash did not ‘donate’ his kidney. His mother did it presumably for the greater good of the greatest number.The patient’s family, which included Prakash himself, wanted to save the life of their sole breadwinner.

As Dr Arun Bal points out (2), informed consent has both legal and ethical aspects.Legally speaking, Prakash’s autonomy was restricted because of his mental disability.It was also the ethical obligation of the family to save Subramanyam’s life.

The mother, in her discretion, presumed her mentally challenged son’s consent, a 1:1 possibility if he were mentally sound. The ‘donation’ might be interpreted as amounting to ‘battery and assault’. It could also eventually protect the quality of life for the family of five. In the circumstances, it was a family obligation fulfilled by Prakash without his being capable of understanding his ‘humane’act.