Ethics In Health Care Essay

Because there are not enough organs available for everyone, some system for allocating scarce resources is needed. Currently there is no one method used to decide who should get an available organ first. The decision making procedure is sometimes called distributive justice theory [1] which states that there is not one â€Å"right† way to distribute organs, but rather many ways a person could justify giving an organ to one particular individual over someone else. Criteria can include: 1. To each person an equal share; 2. To each person according to need; 3. To each person according to effort; 4. To each person according to contribution; 5. To each person according to merit; 6. To each person according to free-market exchanges. Both Mickey Mantle and Todd Krampitz were entitled to a transplant by at least one of these criteria. According to equal access, organs are to be allocated based on objective factors aimed to limit bias and unfair distribution, but there is no truly fair criteria. Length of time waiting, should be balanced with rate of health decline, and age discrimination is unfair as well. The dilemma of whether Mantle or Krempitz should have gotten their transplants is based on our human desire to establish the â€Å"worthiness† of the individual case. Because Mantle caused his liver deterioration by the choice of excessive drinking, it is easy to think him less worthy than a child or adult who had no opportunity to avoid their situation [2]. No one said Krempitz would not have gotten a transplant eventually, or that his need for the transplant was avoidable by his prior actions. Krempitz took advantage of the situation that a clear pathway for transplant decisions does not exist, and bypassed the doctor-valuation process. If the source of the organ would not have donated otherwise, then Krempitz did not do anything unethical since he did not take away someone else’s chance to have that particular organ. If the ad led to additional unplanned donations, then he even helped others. However, if he did step in front of someone else who was â€Å"in line† that would be breaking the rules. But it is unclear whether it is unethical, since it is possible that the rules of the queue are unethical themselves. At best what he did can be considered crass and dangerous, since the possibility existed that someone could have killed someone to get the money offered for the implant. The problem with equal access approach is that some human has to make the value judgment of what is fair and equal access. Some who believe in equal access distribution would also like to have an organ distribution process free of medical or social worthiness biases. Making a decision on whether a person could have avoided their problem by lifestyle choices is effectively a social punishment on those who squandered their health. On the other hand maximum benefit criteria is to maximize the number of successful transplants and minimize waste. This is a resource responsible approach and seems a more reasonable way to make the choice. It also covers those whose lifestyle caused their problems, since more often than not someone who has abused their body has other damage in addition to the organ in question, and should have higher likelihood of dying from other factors, making them less potentially successful than others. According to the Pope [3]: â€Å"The decision on who’s first in line to receive organs can be based only on medical factors, – not a person’s age, sex, race, religion, social standing, usefulness to society or any other criteria.† Personally I think that the choice of who gets the transplant ought to be made first based on the expected prognosis (likelihood the procedure will be successful and the patient have full recovery). For two people for whom there is equal chance of success, then money or insurance should not be the deciding factor on who gets the organ. Instead the age of the person, their responsibilities to other dependent humans (many children etc.), and possibly waiting period should be considered. In this case Mantle probably would not have gotten the transplant since he was not expected to survive long, anyway. [1] The Stanford Encyclopedia of Philosophy webpage. http://plato.stanford.edu/entries/justice-distributive/. [2] Ubel PA, Jepson C, Baron J, et.al. Allocation of transplantable organs: do people want to punish patients for causing their illness? Liver Transplant, 2001; 7(7):600-7. [3] Norton, J., 2000 Catholic News Service http://www.catholicherald.com/cns/transplants.htm SUPPORTERS OF