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Utilitarianism organ allocation
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Recommended: Utilitarianism organ allocation
Lindsey, Thank you for your insightful evaluation and responses to the questions presented this week. As you stated, health care rationing often takes many shapes and forms. Organ allocation is an excellent example of current health care rationing. In fact, Rossoff (2014), who is a professor of pediatrics and medicine at Duke University Medical Center and the director of clinical ethics at Duke University Hospital, also noted organ allocation as a current form of health care rationing in his book titled Rationing is Not a Four-letter Word: Setting Limits on Health Care. I also really appreciated your awareness of the complications associated with complex medical procedures, such as lasik eye surgery, for geriatric patients. There are many
factors to consider when caring for older adults. If postoperative care instructions can not be followed, that must be considered prior to providing surgical interventions. Additionally, patients must also be capable of reporting symptoms which would require further evaluation (American Refractive Surgery Council, 2016). I firmly believe complex procedures must be considered on an individualized basis, depending on support systems in place and risk versus benefit. For example, if an older adult is a good surgical candidate and would gain improved quality of life, who are we to withhold care? This is certainly a topic which requires careful consideration of justice, and biomedical ethical reflection. American Refractive Surgery Council. (2016). Beyond Seeing Clearly: What to Expect with Lasik Recovery. Retrieved from https://americanrefractivesurgerycouncil.org/what-to-expect-with-lasik-recovery/ Rosoff, P. M. (2014). Rationing is Not a Four-letter Word: Setting Limits on Health Care. Cambridge, MA: MIT Press.
However, Saunders begins his argument by arguing that the current opt-in system leads to a shortage in the supply of organs and this is a major concern. This results in numerous people who need organs dying while on waiting lists and also suffering while waiting for transplant as one of their organs is failing. This is Saunders’ first premise to support his conclusion to put an opt-out system in place. By putting an opt-out system in place, this will contribute to an increase in the supply of organs.
Sicko, a film by Michael Moore was released in 2007. The film investigates health care system in the United States. One would definitely get amazed by the facts and figures explained in this documentary. The movie explains failing health care system in the United States. America has advance medical technology, big hospitals, and educated health care professionals, but these facilities are not universal. The film starts by talking about true American stories; what some people have experienced from current health care system, those who had and did not had health insurances. The story starts by Adam, one of 50 million people in America who does not have health insurance. Due to an accident Adam required a medical treatment, but for the reason of not having any insurance he puts stitches on his leg by himself. The second story was about Rick, who accidentally cut the top of his two fingers, middle and the ring while working on the table saw. As a result of not having health insurance, Rick could not put the top of his middle finger back because it was costing 60,000 dollars and he did not had the money. So, he decided to put his ring finger back because it cost 12,000 dollars which he could afford. The movie does not go into the detail of 50 million people who do not have health insurance, but it’s about 250 million Americans who do have health insurance.
Primarily, it is important to clarify Daniels’ views on the allocation of health care. As said in Lewis Vaughn’s Bioethics
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.
An issue that is widely discussed and debated concerning the United States’ economy is our health care system. The health care system in the United States is not public, meaning that the states does not offer free or affordable health care service. In Canada, France and Great Britain, for example, the government funds health care through taxes. The United States, on the other hand, opted for another direction and passed the burden of health care spending on individual consumers as well as employers and insurers. In July 2006, the issue was transparency: should the American people know the price of the health care service they use and the results doctors and hospitals achieve? The Wall Street Journal article revealed that “U.S. hospitals, most of them nonprofit, charged un-insured patients prices that vastly exceeded those they charged their insured patients. Driving their un-insured patients into bankruptcy." (p. B1) The most expensive health care system in the world is that of America. I will talk about the health insurance in U.S., the health care in other countries, Jeremy Bentham and John Stuart Mill, and my solution to this problem.
The facts bear out the conclusion that the way healthcare in this country is distributed is flawed. It causes us to lose money, productivity, and unjustly leaves too many people struggling for what Thomas Jefferson realized was fundamental. Among industrialized countries, America holds the unique position of not having any form of universal health care. This should lead Americans to ask why the health of its citizens is “less equal” than the health of a European.
An important factor in debates over health care and treatment strategies is the issue of cost. It is tremendously expensive to provide the state-of-the-art care that the modern hospital offers. Concerns about where the money will come from to care for elderly citizens appear to be making the case for "mercy killing" even more compelling. Under financial pressure, hospitals are exercising their right to deny such expensive healthcare to the aged or seriously ill.
What Seems To Be The Problem? A discussion of the current problems in the U.S. healthcare system.
Overall, the healthcare system in the United States is still broken because not everyone is insured and disparities are still evident. More policy evolution is required if the US is going to be a nation state that has completely equal citizens. Health scholars must research more so that they can influence what happens in health policy. I believe the patient’s opinion needs to be included so the system
When it comes to health matters, everyone becomes attentive. People believe that with good health, one can virtually accomplish anything that they desire. This is the reason to as why health is given all the attention. It is important to have a clear understanding of the meaning of the term health, healthcare and systems that are put in place to facilitate healthcare.
Once upon a time, I was a student ignorant of the issues plaguing our nation; issues such as abortion and a frightening scarcity of organ donors meant little to me, who was neither pregnant nor in need of replacement body parts. Today, I fortunately remain a simple witness to these scenarios rather than a participant, but I have certainly established a new perspective since reading Neal Shusterman’s Unwind several years ago.
It is hard to imagine life without health insurance. If you have any type of medical problem that requires attention, and you have appropriate health care insurance, you can be cared for in the finest of private hospitals. You can get great treatment and your ailments, depending on the severity, can be treated as soon as possible. Doctors, physicians and surgeons are willing to put out a big effort if they know that they are dealing with patients who are insured and have the money to go under extensive medical treatment. But imagine life without such luxuries. For example, what happens if a relative requires much needed surgery, but does not have health insurance to cover the procedure? What happens if a lack of medical insurance prevents you or your family from seeing a doctor, which could result in health problems that had not been identified but could have been treated before they became life threatening? These scenarios may seem far-fetched, but these types of situations happen to people who lack health coverage everyday. There is a true story about a patient who was insured and diagnosed with treatable cervical cancer. Unfortunately, she lost her job and with it her insurance. She was then unable to see her private doctor, and was turned away from other hospitals because ?cancer treatment is not considered an emergency in a patient who can?t pay? (?Help for D.C.?s Uninsured?). The woman later died at her home without ever being treated. This example raises the question, since when are people with less money less deserving of health care or appropriate treatment?
Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel.
Resources have always been inadequate for food, economics and healthcare and all scarce resources are rationed in one way or another. Healthcare resources can be in the forms of medicine, machinery, expensive treatment and organ transplantation. For decades, allocation of healthcare resources in an equitable manner has always been the subject of debate, concern and analysis, yet the issue has persistently resisted resolution. Scarcity of resources for healthcare and issue of allocation is permanent and inescapable (Harris, “Deciding between Patients”). Scarcity can be defined in general, in emergency and in crises as well as shortage of certain kind of treatment, medicine or organs. As a result of scarcity of resources, and some people may be left untreated or die when certain patients are prioritized and intention of is that everyone will ultimately be treated (Harris, 2009: 335). Allocation of limited resources is an ethical issue since it is vital to address the question of justice and making fair decisions. Ethical judgments and concerns are part of daily choice in allocation of health resources and also to ensure these resources are allocated in a fair and just way. This paper will explore how QALYs, ageism and responsibility in particular influence the allocation of healthcare resources in general through the lens of justice, equity, social worth, fairness, and deservingness.
The healthcare industry of the Bahamas is divided into two sectors, public and private health care. There are five hospitals, which includes two private hospitals and three public hospitals, and numerous public community clinics along with the many private facilities through which medical services are rendered (Doctors Hospital, 2009). The Princess Margaret Hospital, which is the main public facility, according to Smith (2010) in 1905 was people’s last choice when seeking medical attention. Smith described the then hospital as being partitioned into four areas, “for the sick, indigent, lepers and insane” (Smith, 2010). Smith (2010) further expressed that the medical services were free and those that were financially stable paid for treatment to be carried out at their homes. Today, 108 years later, much has changed within health care arena. Presently, there is an increase in the number of persons resorting to the public hospitals and public clinics for medical attention. For those that are in good financially standings they make use of private hospitals or/and other private medical facilities. While some people may use the public medical facilities by choice there are others whom, because of their income or lack of income, have no other alternative but to fall at the hands of the public services. Too, for many years the Bahamas has had the problem of immigrants from Haiti crossing the Bahamian borders illegally and this therefore results in an increase in the funds allocated for the health care industry. According to McCartney (2010) the Haitian nationals accounted for 11.5% of the Bahamas population, hence adding to the government health care budget (McCartney, 2013). The reality is that the Bahamas is far from winning...