Health Care Ethics and Medical Law
Instructor: Kymberly Lum
September 24, 2012
All aspects of health care face the inevitability of moral and ethical issues arising on numerous fronts. The organ donation and transplantation field of medicine is no exception. Each day, approximately 18 people die waiting for an organ to become available for transplant (Taranto, 2010). In the grand scheme of things this may not seem a significant number; however, the fact that over 6,500 individuals with families, friends, and an otherwise productive life will die needlessly every year is obviously a far cry from acceptable. This particular lack of resource does not discriminate. The patients that are affected are children, parents, and grandparents. They are men and women, rich and poor, black and white. Due to the shortage of organs available, there are several resulting ethical dilemmas specific to organ donation and transplantation. Just a few examples are as follows: (1) the questionable status of a brain-dead patient thus the potential withholding of a donation- taking into account the occasional recovery of a patient with severe brain injuries (2) biological cloning and the debatable issue of its helpfulness versus its ethical implications and (3) criteria for selection of recipients thought by some to be discriminatory. Perhaps the largest concern is the perceived favor of the rich over the poor, which has inevitably gone so far as to lend ammunition to the black market and at the very least is causing the general public to question the possible exploitation of donors and recipients; also, the shortage of available resources in the form of viable organs seems only to serve as a reinforcement of this suggestion. It is clear that the somewhat general consensus of favoritism existing among organ transplantation recipients is not without foundation. Media has clearly presented this ethical concept through television series such as ER and well known movies like John Q staring Denzel Washington. Is it not conceivable to suspect that patients who can afford the surgery, required medication, and possible complications are given precedence over patients who can not pay? In fact, this is “the harsh reality of the organ transplant field: Patients who are uninsured or unable to pay are sometimes denied lifesaving treatment because hospitals can't afford to foot the bill for the surgery or the extensive recovery” (Victory, 2006). While the United Network for Organ Sharing (UNOS) is responsible for maintaining the list for patients eligible for organ transplant, which they accomplish by selecting either the most ill patient or patient that has been waiting the longest, UNOS is not responsible for who is actually on the list. That is determined by individual health care facilities and transplant centers. Not only must the patient meet the medical criteria required, set forth in order to optimize the chance for a successful surgery, but he or she also is required to meet criterion established by the health care center. The review preformed by the aforementioned facilities and centers most likely consists of a look at the financial means of paying for the procedure. If a patient can not afford the procedure, they may not make it on to the UNOS list. Furthermore, a patient with means may be able to take their pick of facility while a patient with out will have to settle for what is available or what is close (Victory, 2006). The exploitation of donors is also a concern stemming from the economic aspect of the organ transplantation process, a concern with clear ethical repercussions. Earlier it was mentioned that the prolonging of the life of a patient with severe brain damage may ultimately lead to the denial of organ donations for a patient with a chance at life for however long the patient is kept alive. If two patients are on life...