I was reading this article the other day and this doctor
named Dr. Ezekiel Emanuel,
who is also an author and a professor on medical ethics was talking about on
choosing donor recipient. He said that there is a severe shortage of these
vital organs that could eventually save someone’s life. He said that everyday
18 people die because there wasn’t an organ available and out of 123,000
patient only 15,000 can get an organ. So he
gave a scenario where three people need a liver transplant. One of the three is
a 71-year-old man who is a retired electrician who suffers from alcoholism and
has liver cirrhosis. A 22-year-old man who got into a car wreck and has liver problems.
And finally a 4-year-old boy who has some kind of disorder that doesn’t make
his liver function properly so he is on medical support. Basically all of these
people are on their deathbed or close to death and you can only choose one, in
someway this is just like the trolley scenario we discussed in class. With the
limited supply of donated organs, how do we decide who gets priority and who
makes those decisions? The current rule for an organ transplant is done by this
scoring system called meld score. It shows the severity of a person condition
and the goes from 6-40. The high the score is the more likely you are able to
get a transplant. The doctors assess the patient on how functional the
patient’s old organ is? How long will it
function? And which organ is severely damaged that it will damage other organs?
With these questions the doctors compute and finally determine where you stand
on the recipient list. So going back to the scenario, with the meld scoring
system the person who would have got it would have been the old man with liver
cirrhosis. This is were the controversy start, some say that the 22 year old or
the 4 year old should have gotten the liver. They said that the man was already
dying and others said that it wasn’t fair to the other two because the old man
basically drank himself into this situation. So my question to y’all is WHAT
WOULD YOU DO IN THIS SCENARIO? I would personally choose the 4 year old. I feel
that he is too young to be sick and the notion of knowing that he might not be
alive the next day doesn’t set well with me. He is missing too much out of his
childhood. But this isn’t taken into consideration when some one assessed if
they are in need for an organ transplant. I see a flaw in the system. So what
do you guys think about this and whom would you choose to give the liver to?
There isn’t enough information on the three patients given in this scenario to make a decision. What if the twenty-two year old has extensive brain damage as well as a faulty liver? Would that not need to be a consideration in the meld system, too? The four year old may have several failing organ systems. If the seventy-one year old used to be an alcoholic but is the healthiest of the patients then he may be the best, most logical choice. So we can not make a decision based on this information; we need to know more about the meld system and each patients’ condition.
ReplyDeleteAlthough Rachel brings up a good point, if I had to choose one of the patients based on my own moral standings and disregard the meld system I would choose the 22 year old. Although the 4 year old has more of his life to live, he also hasn't lived as long as the 22 year old and so he has really the least to lose (other than his life) and I would assume that there aren't too many people who depend on the 4 year old. Also, if he is 4 and has this disease it is likely that he was born with it, and if he was born with one problem it could be possible that he could have many other problems. I choose the 22 year old because he hasn't ruined his liver by drinking like the 71 year old, and he only got into a car accident so it is likely that he was healthy before the accident. Since he is older I assume that he has gone somewhere in life and have some people who depend on him in some way shape or form so he would have more to lose by dying. I know there are many flaws in my logic but it is just how I would make my decision.
ReplyDeleteFor this scenario my view is based solely on the conditions provided. I am not saying "what if" in order to make my decision. Therefore, focusing on the health of the patients seems to be the best way to approach this issue. As in, who has the best chance of survival health wise. Of course, this is not an easy thing to say, but since there is a limit of organs it is important to consider who has the highest chance to survive after this transplant. Meaning that, I will have to go with the 71 year old man. Usually I will disagree with this perspective, but when as the scenario stated there is a limit of organs it is crucial that the person getting the organ will most likely survive.
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