Accepting or refusing a donated organ for transplantation: Dr. Jonas’ dilemma

Abstract

The case presents the dilemma faced by Dr. Jonas, the physician responsible for the decision to accept or refuse a kidney for transplant for his patient, Carlos, who has been waiting for a kidney for five years. Dr. Jonas is guided by rationality and science and wants the best for his patient. However, he wants to maintain his excellent success rates in transplants. Carlos is eager to “come back to life” with the transplant, getting out of the terrible dialysis routine. With the death of Sebastião, a kidney is available for Carlos, but he is a 68-year-old donor, and Dr. Jonas is hesitant to accept the non-ideal organ for his 40-year-old patient. The case proves to be opportune to discuss Judgment and Decision Making (JTD) processes, especially the escape from rationality by simplifying behavioral heuristics and their consequent biases. The case was developed to be used in JTD or management disciplines in Health and Healthcare services in lato or stricto sensu postgraduate programs. By discussing the case, students are expected to develop skills to structure decision-making and avoid common behavioral pitfalls.