Case No. 05 CVS 379
IN THE COURT OF APPEALS FOR THE STATE OF WAKE
JEREMY JOHNSON and NANCY JOHNSON,
Appellants,
v.
RUDI JOHNSON,
Appellee.
BRIEF FOR APPELLEE
TABLE OF CONTENTS
TABLE OF CONTENTS ................................................................................................................. i
TABLE OF AUTHORITIES ......................................................................................................... iii
STATEMENT OF THE ISSUE ...................................................................................................... 1
STATEMENT OF THE CASE....................................................................................................... 1
STATEMENT OF THE FACTS .................................................................................................... 1
SUMMARY OF THE ARGUMENT ............................................................................................. 3
ARGUMENT .................................................................................................................................. 4
I.
RUDI SHOULD NOT BE FORCED TO DONATE HIS ORGAN IF HE DOES NOT
CONSENT TO THE OPERATION. ............................................................................ 4
II.
RUDI CAN LEGALLY WITHHOLD CONSENT BECAUSE, BY CONSIDERING
THE RISKS AND ALTERNATIVES, HE HAS DEMONSTRATED MATURITY
TO UNDERSTAND THE NATURE AND CONSEQUENCES OF HIS DECISION.5
III.
SUMMARY JUDGMENT SHOULD BE AFFIRMED WHEN THE GUARDIAN
AD LITEM, AFTER INDEPENDENT INVESTIGATION, RECOMMENDS THAT
RUDI SHOULD NOT PARTICIPATE IN THE TRANSPLANT BECAUSE IT IS
AGAINST HIS BEST INTEREST AND THE JUDGMENT OF HIS PARENTS IS
CLOUDED. .................................................................................................................. 7
IV.
IF THE DECISION OF RUDI OR THE GUARDIAN AD LITEM IS REVIEWED,
THE BEST INTEREST STANDARD APPLIES BECAUSE RUDI HAS NEVER
BEEN ABLE TO EXPRESS LEGAL INTENT AS TO ORGAN DONATION, THE
TRANSPLANT WOULD BE CONTINGENT ON AUTHORITY TO FORCE
RUDI’S BROTHER TO PARTICIPATE AND ON MEDICAL PROBABILITIES
OF SUCCESS, AND THERE ARE REASONABLE MEDICAL ALTERNATIVES..
....................................................................................................................................... 9
A. A liver donation is against Rudi’s medical interest because he could die from the
procedure or suffer permanent damage, and he fears these risks and has a low
tolerance for pain. ................................................................................................. 11
i
B. A liver donation is against Rudi’s psychological interest because he will likely
blame himself if the transplant is not successful and will resent his parents and
brother for the pain and any medical complications from the operation. ............. 12
CONCLUSION ............................................................................................................................. 13
ii
TABLE OF AUTHORITIES
Curran v. Bosze, 566 N.E.2d 1319 (Ill. 1990)
Hart v. Brown, 289 A.2d 386 (Conn. Super. Ct. 1972)
In re Richardson, 284 So.2d 185 (4th Cir. 1973)
Lausier v. Pescinski, 226 N.W.2d 180 (1975)
Little v. Little, 576 S.W.2d 493 (Civ. App. Tex. 1979)
McFall v. Shimp, 10 Pa. D. & C. 90 (C.P. 1978)
People v. E.G., 549 N.E.2d 322 (Ill. 1989)
Revised Code Wash. Ann. 26.12.175
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STATEMENT OF THE ISSUE
SHOULD RUDI JOHNSON, A MINOR, BE FORCED TO UNDERGO SURGERY
AGAINST HIS WILL TO DONATE HIS LIVER TO HIS BROTHER, WHEN RUDI
COULD DIE FROM THE OPERATION, HIS BROTHER COULD RECEIVE A
TRANSPLANT FROM ANOTHER SOURCE, AND THE GUARDIAN AD LITEM
AGREES THAT A TRANSPLANT IS NOT IN RUDI’S BEST INTEREST?
STATEMENT OF THE CASE
This action arises out of a dispute between the parties as to whether parent-guardians
have the right to compel organ donation by their children. On August 9, 2012, Plaintiffs Jeremy
and Nancy Johnson (the Johnsons) sued their minor son, Defendant Rudi Johnson (Rudi). They
seek a declaratory judgment that as his parents and legal guardians, they have the right to force
Rudi to donate part of his liver to his brother Chad Johnson (Chad) who needs a transplant. On
August 17, 2012 Defendant filed an Answer. Following discovery, Defendant then filed a
Motion for Summary Judgment on August 25, 2012. The Superior Court judge granted Rudi’s
Motion for Summary Judgment on January 17, 2013, finding no genuine issue of material fact,
because parents may not force their children to participate in “unwanted intrusions solely for the
benefit of another.” This Court granted the Johnsons’ motion for an expedited appeal. This
matter is now before this Court.
STATEMENT OF THE FACTS
Rudi Johnson does not want to undergo a medical operation to remove a part of his liver for
transplant to his fourteen-year-old brother Chad. Although Chad does not want to force Rudi, the
brothers’ parents want a court to compel Rudi to participate in the surgery. Rudi’s father
acknowledged that “even if it meant certain death [Chad] probably wouldn’t force his brother
into it.” A psychiatrist and Guardian Ad Litem, who each met with Rudi, both advise against
forcing Rudi to donate.
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Rudi could suffer permanent damage from blood clotting or excessive bleeding as a result
of the operation, and there is a slight chance that Rudi will die from anesthesia during the
surgery. Because Rudi is smaller in stature than Chad, a large part of the right lobe of Rudi’s
liver would be taken, which would prolong his recovery period.
The operation would prohibit Rudi from physical activities such as running and
swimming for at least six months. He would miss the entire football season, which may set him
back and prevent him from making the football team next year. The surgery would
There is a one-in-twenty chance that a liver transplant from Rudi will fail for his brother.
Chad could receive a liver donation from one of his parents, with a 75% chance of success.
Chad could also receive a transplant from a cadaver, and he is on the cadaveric donor list.
Additionally, another person could donate part of their liver to Chad.
Rudi understands that he is in a position to help his brother. He knows that there are
alternatives to him donating, and he understands that the alternatives are not equivalent. Rudi
loves his brother and says that he would consent to the transplant if there were no available
alternatives. However, Rudi is afraid of doctors, hates going to get shots, and knows that major
surgery would be much worse. He is informed of the risks and chooses not to assume them, in
light of Chad’s alternatives.
A psychiatrist who met with Rudi recommends against the operation. “Although Rudi is
only ten years old,” and although Rudi’s grandfather is the only person Rudi knows who has died
during his life, the psychiatrist concluded that “[Rudi] seems to have a rather complete idea of
what is going on.” Rudi will not regret refusing to participate in the transplant, and any remote
chance of this is outweighed by the immediate and lasting resentment of his parents if they force
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him to donate his liver to his brother. “Trauma and regret towards Rudi’s parents will almost
certainly result” if Rudi is forced to participate.
The court appointed Christina Smith as Guardian Ad Litem for Rudi, and she also
counsels against forcing Rudi to undergo the surgery. Ms. Smith met independently with Rudi’s
parents and concluded that their judgment is clouded by their desire to see Rudi’s brother
healthy. The Johnsons made a utilitarian decision but did not give Rudi’s opinion appropriate
weight. Ms. Smith also met independently with Rudi and learned that he is scared of the surgery
and dislikes the short and long-term consequences of the operation on his ability to swim and
play football. After reviewing both the psychological and medical reports, Ms. Smith concluded
that Rudi should not be forced to donate his liver because of the nature of what is being asked of
him, the medical risks, and his own decision not to participate. This Court now must decide
whether to uphold summary judgment and the decisions of Rudi, the Guardian Ad Litem, and
psychiatrist, and refuse to force Rudi to donate his organ to his brother.
SUMMARY OF THE ARGUMENT
This Court should not force Rudi to donate his liver to another person against his will
because there is no duty under the law for a person to donate his organs, even if it means certain
death for the other individual. Although Rudi has not reached the age of majority, under the
mature minor doctrine, his choice not to donate should be respected like an adult’s because he
has demonstrated maturity in reaching his decision. Rudi understands the nature of the operation
and the implications for both himself and his brother, and Rudi has weighed the alternatives for
his brother against the risks to himself. Rudi’s Guardian Ad Litem agrees with his decision not
to participate in the transplant, noting his reasons, his interest, and the clouded judgment of his
parents who want to see Rudi’s brother healthy.
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Summary judgment refusing to force Rudi to donate his liver to his brother should be
upheld because the operation is not in Rudi’s best interest. Rudi’s parents may not substitute
their judgment for his by consenting to the surgery on his behalf. Instead, the decision whether
or not to force Rudi to donate his liver must be made based only on Rudi’s best interest. Because
Rudi has never been legally competent to express his preferences about organ donation, there is
nothing to guide his parents in making the decision for him under the substituted judgment
doctrine. Forcing Rudi to donate his liver is against his medical and psychological interests.
There is a risk that Rudi could die or suffer permanent damage from the operation, and Rudi will
almost certainly feel trauma and regret towards his parents if they force him to participate.
Additionally, Rudi’s brother could receive a transplant from sources other than Rudi, including
from Rudi’s parents, and have a 75% or more chance of success. Therefore, Rudi should not be
forced to undergo the surgery and respectfully requests that summary judgment be upheld.
ARGUMENT
I.
THIS COURT SHOULD NOT FORCE RUDI TO DONATE HIS ORGAN IF HE
DOES NOT CONSENT TO THE OPERATION.
The law does not impose a duty for individuals to donate their organs to other people who
need transplants. McFall v. Shimp, 10 Pa. D. & C. 90, 91 (Pa. Com. Pl. 1978). This is true even
if it means certain death for the other person. Id. The rule that “one human being is under no
legal compulsion to give aid . . . to save another human being is founded upon the very essence
of our free society.” Id. Because our society respects the rights of the individual, the decision to
donate one’s organs rests with the requested donor. Id. No person or court may force a
competent individual to donate his organs against his will. Id.
An incompetent person is presumed incapable of giving or refusing legal consent to
medical procedures or property transfers. Children under eighteen years of age (minors) are
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considered incompetent for purposes of legal consent. Id. A minor’s guardian, typically his
parents, may give legal consent for procedures that are medically necessary for the minor.
However, donating an organ to another person is not medically necessary for the donor.
Whether parents may give legal consent for procedures that are not medically necessary for a
minor is a case of first impression in the state of Wake.
No competent adult can be forced to donate his organs against his will, and Rudi should
not be forced either. Organs are donated for the benefit of others. People should “certainly” not
take advantage of an incompetent individual; rather, people should “particularly” protect the
interests of incompetents. In re Guardianship of Pescinski, 226 N.W.2d 180, 182 (1975). Rudi’s
interests should be protected, and he should not be taken advantage of for the benefit of his
brother. “In the absence of real consent” by the incompetent, and when benefit to the
incompetent is not established, a court cannot force an incompetent individual to participate in a
donative medical operation. Little v. Little, 576 S.W.2d 493, 497 (Civ. App. Tex. 1979).
Therefore, Rudi should not be forced to participate against his will.
II.
RUDI CAN LEGALLY WITHHOLD CONSENT BECAUSE, BY CONSIDERING
THE RISKS AND ALTERNATIVES, HE HAS DEMONSTRATED MATURITY
TO UNDERSTAND THE NATURE AND CONSEQUENCES OF HIS DECISION.
Competence or incompetence to consent is merely a presumption that can be overcome.
An adult is presumed competent to provide or refuse legal consent to medical treatment and
property transfers, including organ donation. This presumption can be overcome when the adult
is proven mentally or physically unable to give or withhold consent. Similarly, under the mature
minor doctrine, the presumption that minors are incompetent can also be overcome when the
minor demonstrates sufficient maturity to provide or refuse consent. In re E.G., 549 N.E.2d 322,
328 (Ill. 1989). The legal age of consent is not “an impenetrable barrier that magically precludes
5
a minor from possessing and exercising certain rights normally associated with adulthood.” Id.
at 325.
The mature minor doctrine permits Rudi to legally decide whether to undergo the
operation to donate his liver to his brother. In Little, a mentally deficient minor, Anne, wanted to
donate her kidney to her brother, who would die without a transplant. Little, 576 S.W.2d at 494.
So far as she could, Anne consented to the transplant. Id. The Texas Court of Civil Appeals
assumed that Anne was incapable of understanding the nature of death, but there was evidence
that she understood the concept of her brother’s absence. Id. at 498. Therefore, that court
upheld her decision. Id. at 500.
Just as Little upheld the minor’s choice to consent to organ donation, this Court should
uphold Rudi’s choice to withhold consent. Anne did not likely understand the nature of death,
just as Rudi might not. Yet Rudi understands the implications of his decision for his brother, just
as Anne understood the concept of her brother’s absence if she did not consent to the transplant.
Rudi knows that his brother is sick and that he is in a position to help. Rudi loves his brother and
knows that the alternatives to him donating are not medically equivalent for his brother. Like
Anne, who decided whether to participate in the transplant based on an adequate understanding
of the situation, Rudi chooses not to participate based on a mature understanding of the
information. Therefore, this Court should respect Rudi’s decision, just as the Texas Court of
Appeals respected Anne’s decision in Little.
Rudi has demonstrated the maturity and thoughtfulness that a competent adult would in
coming to his decision. In E.G., a minor with leukemia refused to accept blood transfusions.
E.G., 549 N.E.2d at 323. Doctors predicted that she would die in a month without transfusions.
Id. A medical doctor and psychiatrist agreed that E.G. was mature for her age, sincere, and
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competent to understand the consequences of refusing treatment and to make an informed
decision. Id. at 323-24. E.G. testified that she did not wish to die, but rather her decision to
refuse treatment was grounded in her religious convictions. Id. at 324. The trial judge held that
she was mature to make her own choice whether to refuse treatment. See id. at 328 (setting
precedent for the mature minor doctrine but refusing to remand to the trial judge for a finding
that E.G. was a “mature minor” because she had reached the age of majority at the time of the
court’s decision).
Rudi, like E.G., is sufficiently mature to decide for himself whether to refuse consent.
Like E.G., whom doctors found mature for her age, a psychiatrist concluded that “although Rudi
is only ten years old, he seems to have a rather complete idea of what is going on.” Rudi
understands that his brother is sick and that he is in the best position to help. Rudi knows that
there are alternatives to him donating his liver and that these alternatives are not medically
equivalent for his brother. Just as E.G. decided to refuse consent after weighing her religious
convictions, Rudi decided to refuse consent after weighing his fears, risks, and consequences of
donating. Rudi loves his brother and did not come to his decision based on any desire to hurt his
brother, just as E.G. did not come to her treatment decision based on any desire to die.
Therefore, just as the Illinois Supreme Court found E.G. competent to refuse consent to blood
transfusions, this Court should not find Rudi competent to refuse consent to organ donation
under the mature minor doctrine.
III.
SUMMARY JUDGMENT SHOULD BE AFFIRMED WHEN THE GUARDIAN
AD LITEM, AFTER INDEPENDENT INVESTIGATION, RECOMMENDS THAT
RUDI SHOULD NOT PARTICIPATE IN THE TRANSPLANT BECAUSE IT IS
AGAINST HIS BEST INTEREST AND THE JUDGMENT OF HIS PARENTS IS
CLOUDED.
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Courts appoint Guardians Ad Litem to independently assess and advocate for the child’s
best interest. Revised Code Wash. Ann. § 26.12.175 (West 2006). The guardian should not
assume a passive role in hearings or “rubber-stamp” the parent’s decision. See Little, 576
S.W.2d at 499. A guardian may assume a role adversarial to the parents. Id. Courts have
enforced the guardian’s recommendation to refuse medical treatment for a child over a
conflicting preference by the parents. See, e.g., Pescinski, 226 N.W.2d at 181.
The Superior Court appointed Christina Smith as Guardian Ad Litem for Rudi. Ms.
Smith assumed an active role to make an independent determination whether Rudi should
undergo surgery to donate his liver. First, Ms. Smith met independently with Rudi’s parents.
She concluded that their judgment is clouded by their desire to see Rudi’s brother healthy.
Rudi’s parents made a utilitarian decision to support the transplant, but they did not weigh Rudi’s
opinion appropriately.
Next, Ms. Smith met independently with Rudi. She determined that Rudi understands
what is involved in the surgery and can articulate rational reasons for his desire not to participate.
His reasons include his fear of the operation, the short and long-term effects of the operation on
his ability to play football, and his desire to swim at the pool with his friends, which the
transplant operation would prevent him from doing.
Ms. Smith also reviewed Rudi’s psychological reports, as well as the deposition of the
performing surgeon. Ms. Smith concluded, in her professional opinion, that Rudi should not be
forced to donate his liver because of the nature of what is being asked of him, the medical risks,
and his desire not to participate in the transplant. Because the purpose of a court-appointed
Guardian Ad Litem is to independently assess the child’s best interest, which Ms. Smith did, the
guardian’s recommendation to refuse the transplant should be followed.
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IV.
IF THE DECISION OF RUDI OR THE GUARDIAN AD LITEM IS REVIEWED,
THE BEST INTEREST STANDARD APPLIES BECAUSE RUDI HAS NEVER
BEEN ABLE TO EXPRESS LEGAL INTENT AS TO ORGAN DONATION, THE
TRANSPLANT WOULD BE CONTINGENT ON AUTHORITY TO FORCE
RUDI’S BROTHER TO PARTICIPATE AND ON MEDICAL PROBABILITIES
OF SUCCESS, AND THERE ARE REASONABLE MEDICAL ALTERNATIVES.
If neither Rudi nor the Guardian Ad Litem can make the decision to legally refuse
consent, the doctrine of substituted judgment does not allow this Court to consent on his behalf.
The substituted judgment doctrine sometimes permits a court to substitute its judgment for the
ward’s, based on clear and convincing proof of what the ward’s intent would be if the ward were
competent. See Curran v. Bosze, 566 N.E.2d 1319, 1326 (Ill. 1990); Little, 576 S.W.2d at 497.
Courts have refused to apply the doctrine for children, who have not yet had the opportunity to
develop legal intent with respect to organ donation. Curran, 566 N.E.2d at 1325-26; see also
Pescinski, 226 N.W.2d at 181 (refusing to apply the doctrine for an institutionalized
schizophrenic child). It is not possible to determine what a child’s intent would be if he were
competent, so there is no evidence to guide a surrogate in substituting his or her judgment for the
child’s. Curran, 566 N.E.2d at 1326. Even in jurisdictions which apply the doctrine of
substituted judgment in other situations, it is clear that courts consider the requested donor’s
interests in organ transplant cases. Little, 576 S.W.2d at 498.
Instead of the substituted judgment doctrine, the best interest standard should govern
whether Rudi should be forced to donate his liver to his brother. A court must act only in the
ward’s best interest. Curran, 566 N.E.2d at 1340. A court may not weigh the ward’s interests
against the interests of others. Id. “To measure benefits to one individual against risks to
another is to get on a very slippery slope of determining relative worth of individuals in our
society.” Id. Especially in organ transplant cases between siblings, courts should not weigh one
child’s distress against another child’s benefit; court must treat all children as equals. Id.
9
Therefore, there should be no utilitarian decision to weigh the risk to Rudi against the benefit to
his brother, which is what Rudi’s parents did in choosing to support the transplant.
Even before applying the best interest standard, “it must be clearly established” that the
contingencies are minimal and there are no reasonable alternatives. In re Richardson, 284 So. 2d
185, 188 (La. App. 1973) (Golotta, J., concurring). In Hart, the Connecticut Superior Court
permitted doctors to perform a kidney transplant between minor identical twin sisters because
there were no contingencies and no reasonable alternatives. Hart v. Brown, 289 A.2d 386 (Conn.
Super. Ct. 1972).
The transplant in Hart was not contingent on anyone else’s approval. The parents,
medical doctors, psychologists, and both twins supported the procedure. Id. at 389-90. There
was “no known opposition.” Id. at 391. Further, the success of the transplant in Hart was not
contingent on other medical probabilities. Because the twins were identical, they had the same
genetic material, so there was no risk that the recipient would reject the donated kidney. Id. at
388. Additionally, the prognosis for good health and long life was excellent for both twins. Id.
at 391. Finally, there were no reasonable alternatives. Id. A kidney donation from one of the
parents may have been cruel and inhumane because additional drugs with side effects would
have been needed. Id.
Unlike in Hart, there are many contingencies and reasonable alternatives to Rudi
donating his liver. First, Rudi’s opposition to donating creates legal contingencies, which did not
exist in Hart where there was no opposition. Rudi’s brother, Chad, does not want Rudi to donate
if Rudi is not willing. Their father stated that “even if it meant certain death [Chad] probably
wouldn’t force his brother into it.” Therefore, if this Court is forces Rudi to donate, the
transplant would be contingent on legally compelling Chad to accept the donation. A court
10
would probably have to decide whether Chad could refuse the transplant under the mature minor
doctrine. See E.G., 549 N.E.2d at 322. A court would also likely have to appoint a Guardian Ad
Litem for Chad. If the guardian agreed with Chad’s decision, and if review of the guardian’s
recommendation was appropriate, a court would then have to evaluate whether the transplant
from Rudi would be in Chad’s best interest. These contingencies, which did not exist in Hart,
must be considered in determining whether forcing Rudi to participate is in his best interest.
The success of a liver transplant from Rudi is also contingent on medical factors. In Hart,
there was no risk that the recipient would reject the organ, but there is a one-in-twenty chance
that Chad will reject a transplant from Rudi. Also, in Hart, the prognosis for good health and
long life after the transplant was excellent for both twins, while there is no guarantee that Rudi
would even survive the procedure or recover without permanent damage.
Finally, Chad’s medical alternatives must be considered in deciding whether a liver
donation is in Rudi’s best interest. Unlike in Hart, where a parental donation may have been
cruel and inhumane, a liver transplant to Chad from his parents has a 75% chance of success.
Chad is eligible and listed to receive a liver transplant from a cadaver, which is another
reasonable alternative. Chad could also receive a donation from a healthy unrelated donor.
Under the best interest standard, Rudi should not be forced to donate his liver to Chad because,
unlike the organ recipient in Little, there are multiple reasonable alternatives for Chad and the
transplant is contingent on many legal and medical factors.
A. A liver donation is against Rudi’s medical interest because he could die from the
procedure or suffer permanent damage, and he fears these risks and has a low
tolerance for pain.
Rudi should not be forced to donate his liver because the procedure is against Rudi’s
medical interest. In Little, the Texas Court of Civil Appeals upheld the decision of Anne, a
11
mentally deficient minor, to donate her kidney to her brother. Little, 576 S.W.2d at 494. That
court decided that the transplant was in Anne’s best interest. Id. at 493. The procedure presented
no threat to Anne’s life. Id. at 494. The discomfort that she was predicted to experience from
the procedure was “minimal,” and Anne had an unusually high pain threshold. Id. at 499.
Unlike Anne’s interest in Little, it is against Rudi’s medical interest to force him to
donate his organ to his brother. In Little, the procedure for Anne presented no threat to her life,
but here there is a chance that Rudi will never wake up from the operating table. Also unlike
Anne, Rudi may experience more than minimal pain and discomfort. There are risks that Rudi’s
blood will clot, which could cause permanent damage. Excessive bleeding is another risk, also
potentially leading to permanent damage. Assuming Rudi survives the surgery, his recovery
time would be prolonged because the surgeon must remove of a large portion of the right lobe of
his liver.
Additionally, while Anne in Little had an unusually high pain threshold, Rudi has a low
threshold. The psychologist, Guardian Ad Litem, and Rudi’s father all confirmed Rudi’s
statements that he is afraid of doctors, hates going to get his shots, and knows that major surgery
would be much worse. Because of these risks, and Rudi’s fear of them, the donative operation is
against Rudi’s medical interest.
B. A liver donation is against Rudi’s psychological interest because he will likely
blame himself if the transplant is not successful and will resent his parents and
brother for the pain and any medical complications from the operation.
Compelling Rudi to donate his liver to his brother is against Rudi’s psychological
interest. First, there are no psychological benefits ten or twenty years down the road for children
who donate their organs. Curran, 566 N.E.2d at 1335. Thus, Rudi would not benefit
psychologically from donating. Second, refusing to compel Rudi to donate would not cause him
12
any psychological damage. The psychiatrist who examined Rudi concluded that any remote
chance that Rudi would regret not participating is outweighed by the immediate and lasting
resentment that Rudi is likely to feel towards his parents and brother if he is forced to participate.
A third reason the surgery is against Rudi’s interest is that there are “substantial” risks
that organ donation by minors is psychologically damaging. Curran, 566 N.E.2d at 1336. Rudi’s
father agreed that “if something goes wrong with Chad, Rudi will probably blame himself.”
Because there is a one-in-twenty chance that Chad will reject a transplant from Rudi, there is a
significant chance that Rudi will blame himself and suffer psychological damage if he is forced
to participate.
Additionally, “trauma and regret towards Rudi’s parents will almost certainly result” if he
is forced to donate. For example, Rudi might feel regret if there are any medical complications
for himself or his brother. Rudi also might resent his parents and his brother for not being able to
engage in ordinary childhood activities, such as playing football and baseball and going to the
pool. Rudi may also feel lasting resentment if he does not make the football team next year,
because he might reasonably view his failure to make the team a result of being forced to miss
the current season to recover from the operation. It is very likely that Rudi will feel some kind of
resentment if he is forced to participate, and he will not gain any psychological benefit from
donating, nor will he suffer psychological harm if he does not donate. Therefore, forcing Rudi to
undergo surgery to donate his liver to his brother is against Rudi’s psychological interests, and
summary judgment should be affirmed.
CONCLUSION
Rudi Johnson is mature and informed, and he does not want to participate in a surgical
operation removing part of his liver to transplant it into his brother. There are serious medical
13
and psychological risks to Rudi if he is forced to donate his liver to his brother, and Rudi will
receive no benefits from participating. There are reasonable medical alternatives for Rudi’s
brother, and Rudi’s Guardian Ad Litem found that the transplant is not in Rudi’s best interests.
Defendant respectfully requests that the trial court’s grant of summary judgment be upheld,
refusing to force Rudi Johnson to donate his liver to his brother against his will.
/s/
Tory James
Attorney for Defendant
520 Wait Dr.
Deacon City, Wake 27906
(556) 927-5017
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