"Herrick brothers with the transplant team"  1955, On View: Digital Collections & Exhibits, Center for the History of Medicine at Countaway Library

Medical Issues

"Moreover, the surgical procedure needed to remove Ronald’s kidney contained undeniable risks—complications from general anesthesia, hemorrhage, accidental injury of a nearby vital organ, infection."

~ Joseph E. Murray, "The Fight for Life" By Joseph E. Murray, ​​​​​​​Harvard Medicine

Richard and Ronald Herrick, Boston.com

Although Richard and Ronald were clearly identical, they had to go through extensive testing to ensure that they were identical, not fraternal. If the twins were indeed fraternal, transplant rejection was inevitable. The team was uncertain if a patient could live with one kidney, so they were hesitant to go through with the surgery knowing that other organs could be damaged as a result. But, with Richard on death's door, there was no other choice.

“A fingerprinting at 4 p.m., today at Roxbury Crossing police station may save the life of a 23-party-old Marlboro man seriously ill in Peter Bent Brigham Hospital.

The fingerprinting is to determine whether Ronald Herrick of East Main street, Marlboro, is the identical twin or merely the fraternal twin of Richard Herrick, critically sick with a kidney ailment.

If the fingerprints of Ronald, when they are taken this afternoon, match his brothers, Ronald can, if he desires, donate a kidney that may save Richard's life.

If the fingerprints do not match, it still is not definite that the two boys are only fractional twins. Doctors then will be forced to rely on a skin graft the size of a thumbnail they made from Ronald to Richard five weeks ago.”

-Boston Herald, “Twins Life May Hang on Fingerprint Today,” December 1954.

Joseph E. Murray, American College of Surgeons

"The anatomical hurdles were low, however, compared to the immunological one: How could a transplanted organ avoid rejection? Before human organ transplantation could take a first step, we had to solve the immunological challenge-or render it moot. In October 1954,  fate rendered it moot."
~Joseph E. Murray, The Fight For Life, Harvard Medical School

Ethical Issues

"Several days before the operations were scheduled, the press became aware of what was about to happen. Suddenly, the whole world was watching. The media quoted doctors who said the experiment was not only doomed to failure but also unethical."

~Joseph E. Murray, The Fight For Life, Harvard Medical School 

Citizens were angry and would question why the team would continue despite the fact that no procedure had previously succeeded. Unimaginable pressure was building up on the operating team with the  world watching as the day of the procedure was nearing. Operating on Ronald, a healthy person, was breaking a doctor's oath of "doing no harm" to the healthy (Hippocratic Oath). However, the doctors had made up their minds.

The Hippocratic Oath, 2010, The Medical Futurist

"Any form of medical treatment is a balance betweeen intended good and potentially adverse effects. For the healthy donor, however, there is no physical benefit. For us surgeons who had been taught to make sick persons well, subjecting Ronald, a healthy donor, to an extensive surgical procedure required a basic qualitive shift in our thinking.   To this extent, we were compromising the physician's injunction to 'do no harm.' Therefore, we had to assume that the low risk to Ronald was justified by the expected benefits for Richard. Only after a series of consultations involving experienced physicians within and outside the Brigham, clergy of all denominations, and legal councel did we feel comfortable offering the option of transplantation to Richard, Ronald, and, by extension, their family."

~Joseph E. Murray, "Surgery of the Soul: Reflections on a Curious Career", 2001