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Teenager and the transplant: how the case of William Verden highlights action is needed to optimise equitable access to organs for patients with impaired decision-making
  1. Bonnie Venter1,
  2. Alexander Ruck Keene2,3,
  3. Antonia J Cronin4,5
  1. 1Centre for Health, Law, and Society, University of Bristol, Bristol, UK
  2. 239 Essex Chambers, London, UK
  3. 3Dickson Poon School of Law, King's College London, London, UK
  4. 4Transplant Renal and Urology Directorate, Guy's and St Thomas' Hospitals NHS Trust, London, UK
  5. 5Centre for Nephrology, Urology and Transplantation, King's College London, London, UK
  1. Correspondence to Bonnie Venter, Centre for Health, Law, and Society, University of Bristol, Bristol BS8 1HH, UK; bonnie.venter{at}


In February 2022, the Court of Protection was faced with the question of whether a kidney transplant was in the best interests of William Verden. The case highlighted the legal, ethical and clinical complexities of treating potential kidney transplant patients with impaired decision-making. Above all, it exposed the potential risk of discrimination on the basis of disability when treatment decisions in relation to potential kidney recipients with impaired capacity are being made. In this paper, we draw on the Verden case to (1) examine the role of the Court of Protection in cases relating to patients with impaired decision-making capacity who require a transplant, (2) to highlight the lack of empirical data on patients who have faced inequitable access to transplant and (3) highlight the shortcomings of the existing legal and regulatory framework in England and Wales guiding clinical decision making for patients in William’s position. We consequently argue that there is a clear need for action to ensure equitable access to transplant for those in William’s position. Furthermore, we suggest that there is a responsibility incumbent on policy makers and clinicians alike to develop a meaningful, and meaningfully operational, framework centred on preventing discrimination against potential organ recipients based on their decision-making capacity.

  • transplantation
  • ethics
  • policy
  • mental competency
  • decision making

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  • Contributors BV, ARK and AJC conceived the article and, in online discussions, worked out the structure and content. BV, ARK and AJC drafted the manuscript and critically revised it. All authors finalised and approved the submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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