Alcoholics and Liver Transplants

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Eunice Bingley
PH 442 Bioethics
08/31/2012
Critical Summary 3 ("Alcoholics and Liver Transplantation")
Many moral, ethical, and medical issues are raised in “Alcoholics and Liver Transplants” (JAMA, March 13, 1991, Vol. 265, pp. 1299-1301). The authors, Carl Cohen and Martin Benjamin dissect the many arguments against giving liver transplants to those who abuse alcohol.

Alcoholic cirrhosis of the liver, severe scarring due to the heavy use of alcohol is by far the major cause of end-stage liver disease. Cohen and Martin do not believe that someone that has induced this disease by alcohol abuse is no less deserving of a liver transplant than someone that takes care of their self. They support the moral argument by stating, “If alcoholics should be penalized because of their moral fault, then all others who are equally at fault in causing their own medical needs should be similarly penalized”.

One of the medical arguments that the authors combat is that liver transplants performed on alcoholics have a lower success rate then non-alcoholics. Statistics are presented in the text to argue this notion which really strengthens this aspect of the argument. They also state that a candidate for any other procedure would not be excluded because of the risk of success rate.

This argument rises and falls based on what side you’re on. One could assume that most people waiting for a liver, who have never had a drink in their life would be very reluctant to side with this argument. However, an alcoholic or recovering alcoholic that needed a liver would more than likely be behind this passage all the way. One of the weaknesses of this argument was the comparisons that were made with other procedures. A reason why a doctor may be reluctant to transplant a liver to an alcoholic is the scarcity of the organ itself so comparing it to another organ that may be more abundant is asinine. Overall, this argument was moderately effective for the aforementioned reasons but I...
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