“I have asked myself that eleven times since your letter arrived, and the honest answer is that under the framework I operate in, no.

The surrogate was legally authorized.

He gave me a clear account of your condition.

I had no reason to doubt him and no mechanism for verifying him, and if I went and independently assessed every family member’s report I would not be an ethicist, I would be an investigator, and the role does not permit it.

“That is the correct answer and I want you to have it because you deserve an accurate one rather than a comforting one.

“I also want to tell you that I have changed one thing about how I practice, and I changed it in the week your letter arrived.