Risk involved and the ethical implication
Organ transplant is a risky endeavor regarding finding the right match and the whole process of performing the transplant. In this case, the risk increases with the lack of organs donations and the patients are forced to wait for someone to donate. The risk of death before the right organ is found been increasing and for this reason, doctors are forced to make various decisions on the patient who is to receive the organ. In some cases, they may be unable to make the right decision, or they get biased. Such occurrence brings about the risk in the patient health. In the hospital committee case, Misty, two older individuals, an accountant, a teacher and a truck driver face different risk.
The second concept of ethical implications and legal complication affects the organ donation and transplant. In this case, the doctors are supposed to make a critical decision concerning who is to receive the organ first. The decision needs to be backed by a strong evidence so that someone should have a life-saving treatment. In this case, the ethical consideration is regarding utility, justice, respect for persons. In utility considerations, transplant should be undertaken to benefit the critically ill patients. It is aimed at achieving the more aggregate good. In the application of the principle of utility, the doctors use the evidence available on the medical condition (Procurement & Network, 2015). The justice principle considers the equity of access by patients to organ transplant by ensuring equitable allocation of donated organs among patients. The justice principle tries to achieve fairness in the distribution of benefits and burdens of organ procurement and allocation although it does not mean treating all patients the same. Instead, considerations are made on giving equal concern and respect. The last consideration is respected for persons where physicians owe humans a respect by considering the moral requirement of fidelity to commitment and honesty.
In the hospital committee case, some ethical considerations were not made in allocating Misty the kidney before the others who were ahead. In such case, both ethical and justice considerations were not made. First, two older individuals were facing higher risk to their health as compared to Misty and needed the transplant first. When the committee placed Misty at the top of the list and scheduled her for surgery immediately, they did not consider the respect for persons, justice, and utility. The family of the teacher and the truck driver who died have a right to sue the hospital for discrimination and acting against the set ethical and risk considerations in allocating the organ. Someone influence or social status is not a consideration for priority scheduling of the transplant. The health care providers fell below an acceptable standard of care.
Rationale on resolution
In most cases, a legal action is taken where the person feels that some justice was not served and wants the court to determine a compensation or offer a direction on future situations. In such case, the committee needs to come out and defend the reason that they placed Misty before the other patients who were ahead. The resolution would involve financial compensation and an official apology from the hospital. Financial compensation is determined by the court, and the hospital is obliged to meet it. In such the affected individual is compensated to make them feel that the institution accepted their wrong doing. Additionally, a formal apology is needed to communicate to the affected person the factors that led to the mistake as well as the position of the hospital on the whole situation and the plans they have to avoid such occurrence. In the apology, the committee would have determined which mistake was committed, prior cases of such mistakes and how they have reprimanded those who were involved.
Legal and ethical issues
According to the distributive justice and ethics determined by University of Washington school of medicine, there should be equal access and maximum benefit. Although these distributive methods are accepted, they face problems in terms of the ethical determination of equal access and maximum benefits (Caulfield and Ries 2006). Regarding maximum benefits predicting medical success is difficult as a successful outcome is varied, distribution of organs using this procedure is open for bias, lying and favoritism and that age argument as criteria for distributing organs devalue the remaining life of an older person who needs a transplant. In terms of equal access, a distribution based on individual worth is biased against worthy individuals when individual worthiness factors are not included such as in tobacco and alcohol which ruined their organs (Center for Bioethics, 2004).
Stakeholders who invested in outcome
In the case of the hospital committee case, the hospital administration and policy makers were the highest stakeholders in the problem that arose. They were unable to address how priority is determined in allocating organs to patients. The doctors as stakeholder should have advised the hospital committee on the patient who urgently needed the transplant and outlines the reason they were to be given the priority. The family, on the other hand, should have investigated the process through which the organs were allocated to the patient so as to make sure that their patients were safe and would receive the best care. To solve the issue, there needed to be ethical code to be followed, an establishment of a protocol and regular review of codes.
It evident that there are tensions emerging in the application of the ethical principles of utility and justice due to upholding equal access and maximum benefits in organ allocation and transplant. It is equal difficulty to predict legal challenges (Hackler & Hester, 2005). For this case, the allocation standards need to be based on the best available evidence and consistently applied. Prioritizing of patients should be based on the best available evidence relating to clinical outcome and morally relevant factors. Allocation criteria should be free from discrimination and instead asses the medical relevance (Persijn, et al., 2004). The hospital should also address concerned public the criteria in generating a transparent allocation system.
Procurement, O., & Network, T. (2015). Ethical principles in the determinate allocation of human organs.
Hackler C. and D. Hester. (2005) Age and the Allocation of Organs for Transplantation: A Case Study. Health Care Analysis 13: 129-136.
Persijn, et al. (2004) Organ Allocation on the Basis of Medical Criteria: Current International Practices. In T. Gutmann, A.S. Daar and R.A. Sells, Ethical, Legal and Social Issues in Organ Transplantation, Pabst, 33- 40.
Timothy Caulfield and Nola M. Ries (2006). The Allocation of Organs: Emerging Legal Issues. The Canadian Council for Donation and Transplantation. Retrieved from https://professionaleducation.blood.ca/sites/msi/files/Allocation_Legal_Issues.pdfCenter for Bioethics (2004). Ethics of Organ transplantation. Retrieved from http://www.ahc.umn.edu/img/assets/26104/Organ_Transplantation.pdf
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