Equity Issues of Organ Transplantation

The purpose of this research is to examine the equity issues entailed by the phenomenon of organ transplantation, in particular the shortage of organs available for transplant and the high cost of obtaining and implanting donated organs. The plan of the research will be to set forth a review of relevant articles from the health-care professional literature, and then to discuss the compelling evidence against any assertion that organ transplantation praxis can be identified as equitable in U.S. society.

In the environment of health-care delivery in the U.S. in the closing years of the twentieth century, a good deal of attention has been given to the concept of rationing varieties of health care. The prospect of having health care rationed according to the wishes of managed care companies (MCOs) and health maintenance organizations (HMOs) is of relatively recent concern. Managed care, in current usage, is the name given to health-care delivery that is "generally accomplished by reducing access to the most expensive types of care and substituting less expensive interventions." The scope of such care are predetermined by contract, and decisions about referral to care not covered by the contract are made (rationed) by the administrative organization. The bureaucratic form of managed care differs from the traditional fee-for-service concept, and the idea that health-care rationing decisions belong to a bureaucracy is morally repugnant to many Americans. But as Gaylin points out:

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regional-medical-center-based philosophy of donation, such that a local patient would be more likely to receive an organ donated by another local (dead) resident than to come to the number-one spot on a regional medical center's waiting list before the latest celebrity. It is difficult to see how any payment structure for donated organs can avoid succumbing to the slippery slope of professional and/or personal exploitation, politicized post-mortems, or postoperative litigation in marginal cases. In this regard, Fung makes a case for what is called "dignified passage," or voluntary active euthanasia of the hopelessly ill as a response to the high cost of treating them under the current health-care system, which is meant to take the form of converting projected entitlements into death benefits at a discount. Long-term care, Fung points out, costs in the range of $15,000 a year for home care to $60,000 a year for good-quality nursing-home care: "Where long-term care is involved, $75,000 to $300,000 per person can be saved if care is shortened by five years." Fung specifically rejects the view that a right to die implies a duty to die, but the cost-benefit analysis suggest that the terms of discourse in the area of crisis-related me

Category: Medical - E