John Q: an Ethical Analys and Review

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John Q: An Ethical Analysis and Review.

NURS 360
Dr. Schantz
March 8, 2011

Abstract
The film John Q provides a model for the analysis and demonstration of ethical principles of distributive justice as they pertain to healthcare and, more specifically, organ allocation in the face of scarcity. The film portrays the shortcomings of a managed care system as well as the pitfalls of a libertarian approach to allocation. Here discussed are the ethical approaches of Eglitarianism, Prioritarianisn, Utilitarianism, and Libertarianism to organ allocation as they pertain to the film as well as the situational change in the plot if these approaches were considered. The topics of hopelessness and helplessness experienced by the patient and family in a dire circumstances as observed in John Q is confronted in the context of the picture . Also provided is a brief ethical critique of the movie and a personal reaction to the topics addressed in the film

Introduction
When dealing with the issue of scarcity and allocation of resources, the health care industry provides a controversial and ethically challenging model for working though dilemma scenarios such as making distributive decisions with respect to donor organs to the most appropriate recipient. Scarcity is defined as a condition in which the demand for a resource greatly exceeds the supply of the resource, and the fact of the matter is there are many more people that need transplant organs than there are organs to be allocated. This circumstance is well presented in the movie John Q, written by James Kearns. The main point made throughout the film seems to be that the process of organ procurement is not only difficult and trying on the patient and family, but can also be fraught with the dilemmas of resource allocation and providing healthcare using a Libertarian allocation approach that need be addressed by healthcare administrators. Focusing on the theme of distributive justice, the film comes across to imply that care should be made available to all regardless of their ability to pay and allocation be based on a Prioritarianistic “according to their need” distributive model rather than a Libertarian approach to allocation. In modern healthcare there is a constant struggle to provide the most and greatest healthcare to the greatest number of people in society. Fueling the debate over effective care allocation strategies, for decades the media has been filled with the echoes of socialized healthcare, and in recent decades multiple nations have adopted the model of a governmentalized healthcare system. In the United States resides a mixed system supported by tax dollars as well as managed care model that is fueled by the desire to reduce cost and still provide necessary care to subscribers. To that end, the film depicts the short comings of a managed care system with seen in the lack preventative screening that might have led to the recognition a young boy’s heart condition at a time when preventative steps could have been taken to mitigate the situation observed in the film. In the context of resource allocation and particularly organ allocation, at the heart of the ethical issue is the concept of scarcity. According to the University of Minnesota’s Center for Bioethics, there were approximately 83,000 people on the waiting list to receive an organ with an additional 106 (average) being added per day in 2003 (Ethics of Organ Transplantation, 2004). When considered in relation to the 9,800 donors and the roughly 6,000 people that died in 2002 while waiting for a transplant, it becomes clear a point of equilibrium between supply and demand / necessity has yet to be reached (Ethics of Organ Transplantation, 2004). Summary

In the 2002 film, John Q, John Q. Archibald, an American factory worker that has been the victim of a declining economy, and is faced with the difficulty of paying for medical services when his son is struck down at a baseball game with heart failure...
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