INTRODUCTION Over the past years many debates have occurred in the health care sys ten on how priorities of health care should be set. Justice in the health care system entails that resources should be fairly distributed in the society. This means that the services offered to a patient should be balanced based on the medical needs of society in general. Justice in access of healthcare provides that patients who are most sick should be given quality treatment first. However this practice is not appropriate because it denies the patients who are more likely to survive the chance of having a quality life.
(Chapman, Audrey R. , ed. ) The system of allocating heart transplants is based on a waiting list. Patients who have waited for the longest period and who are the most sick are given the first priority when a heart is available for transplant. Patients on a waiting list for a heart transplant are grouped into categories. The first priority is given to patients who are very sick and cannot survive for more than a month without mechanical assistance or inotropic medicines. If they fail to get a heart transplant they die within a month.
The second category includes patients who are medically stable and can live for more than a month without a transplant. These patients are on constant medication and mechanical assistance. The third category includes patients who do not appear in the first two categories. (Kogan, Barry S. , ed. ) Despite the installment of guidelines that assist in giving priority to heart transplant patients, ethical issues have emerged with medical practitioners expressing different views. At times the question of who should be given a heart transplant is based on the patient’s likelihood to survive for a longer time.
Why the heart should be given to Mr. X Mr. X is suffering from a heart failure and has been on the waiting list for a very long time and he is near death. Mr. X has suffered from heart condition for years and he also has bad lifestyle habits. Mr. X was warned against smoking and eating fatty foods because the habits could worsen his condition. Mr. X has two angioplasties and two bypass operations to correct a blockage of heart blood vessels. Mr. X should be given the heart because he has been on the waiting list for a longer period that Ms Y.
Being on the waiting list for a long time makes him eligible for the heart with regard to the Justice guidelines of access to health care. Mr. X is suffering from heart failure and currently he is on mechanical support to prolong his life. As the sickest patient, Mr. X. is eligible for the heart. The heart will most probably save his live because if the transplant is not done Mr. X will die. (Caplan, Arthur L. , and Daniel H. Coelho,) The fact that Mr. X is ignorant and does not want to stop smoking and eating fatty foods, should not be used to discriminate him against getting the heart.
Mr. X has been waiting for a heart, for a period of one year, so denying him the heart would be devastating for him. It would affect him both psychologically and emotionally to know that he was denied the heart because of his lifestyle. Or worse still, if he found out that a patient who had just been put on the waiting list would get the heart. According to the categories put in place to assist in giving priority to patients who need heart transplant, Mr. X is in the first category.
He is a very sick man who is relying on medication and mechanical supports and his chances of survival are minimal. Mr. X, therefore, is the most qualified patient for the heart transplant and the ethical committee should ensure that he gets the heart. Why the heart should be given to Ms Y Ms. Y is a patient who has just been placed on the waiting list for a heart transplant and she can be sustained with medication for some time, till the next heart becomes available. Ms Y is healthier than Mr. X and has a higher chance of survival because she is still stable.
Mr. X is very sick and he is nearing his death, this shows that donating the heart to him would be futile because even with a heart transplant he won’t survive for a long time. His lifestyle habits which include smoking, eating fatty foods and old age will put limitations to his survival. Ms Y, however, has a healthy lifestyle meaning that with a heart donation, the quality of her life could be improved. Smoking and high cholesterol are risk factors for heart problems and will attribute to blockage of the coronary arteries. The fact that Mr.
X says it’s difficult to stop these habits means that even with a heart donation, he will resume his old habits and this will still affect the new heart and aggregate the heart attack. Mr. X’s conditions can be controlled and maintained. To avoid heart problems, he must control his diet and reduce levels of cholesterol in his body. He should also stop smoking and ensure that he has no stress in his life, whether physical or emotional. If he tries to avoid these habits, he can improve his heart quality and survive for a long time without a heart transplant. (Mueller, Keith J.
) This shows that if Mr. X can improve his heart quality then he does not need a heart transplant urgently and so Ms Y should be given the heart. Conclusion My own interpretation The guidelines of Justice to health care state that a patient who has waited for the longest period for a heart donation, is the most eligible for a heart transplant when the heart becomes available. Justice in access to health care also provides that patients who are the most sick and who have minimal chances of survival without a heart transplant should be given the priority of heart donation.
(Smith, Wesley J. ) According to me Mr. X is the most eligible for a heart donation. This is because he has been on the waiting list for a whole year while Ms Y has just been put on the waiting list. Being on a waiting list for a long period is enough evidence to show that he deserves the heart. Based on the guidelines of Justice Access to health care, Mr. X is the sickest patient who is surviving on medication and mechanical support and if not given the heart he could die. He is sicker than Ms Y and this qualifies him more for the heart. Discriminating Mr.
X against the heart donation based on his lifestyle habits is not fair or legal and therefore this should be discouraged. Works Cited Caplan, Arthur L. , and Daniel H. Coelho, eds. The Current Debate The Current Debate. Amherst, NY: Prometheus Books, 1998. Questia. 8 Nov. 2007 <http://www. questia. com/PM. qst? a=o&d=99214875>. Chapman, Audrey R. , ed. A Human Rights Approach A Human Rights Approach. Washington, DC: Georgetown University Press, 1994. Questia. 8 Nov. 2007 <http://www. questia. com/PM. qst? a=o&d=99219813>. Kogan, Barry S. , ed.
A Time to Be Born and a Time to Die: The Ethics of Choice. New York: Aldine de Gruyter, 1991. Questia. 8 Nov. 2007 <http://www. questia. com/PM. qst? a=o&d=65305099>. Mueller, Keith J. Health Care Policy in the United States. Lincoln, NE: University of Nebraska Press, 1993. Questia. 8 Nov. 2007 <http://www. questia. com/PM. qst? a=o&d=105390410>. Smith, Wesley J. The Assault on Medical Ethics in America The Assault on Medical Ethics in America. San Francisco, CA: Encounter Books, 2000. Questia. 8 Nov. 2007 <http://www. questia. com/PM. qst? a=o&d=99201726>.