SHOULD not BE PRIORITISED ACCORDING TO

EqualityDoctor or Arbiter?

Conclusion

Right to risky behaviour

The health practitioner must play an inappropriate role of judging lifestyle factors and their contribution to a patients illness.

FOR AGAINST

StrengthsUndermining the doctor-patient relationship:-Patients may lose trust & withhold information(1,2) -Utilitarianism: can the doctor really do the best for the greater good if the doctor-patient relationship is undermined? (2,3)

Each person is considered of equal worth and equal access to health care should be given, regardless of variable need.

FOR:Egalitarianism: Scarce resources should be allocated on an equal and fair basis (3)Deontology: It is the doctors duty to provide their patients access to health care that they need, regardless of their background Beneficence: act for the good of others, i.e. every patient who wishes to have a transplant should receive oneNon-Maleficence: Denial of access to organs based on lifestyle factors could cause considerable harm to the patient (6).Universality: If organ transplants are prioritised based on lifestyle, then all health care should be prioritised accordingly. This is unfeasible.

AGAINST:Justice: “Equals should betreated equally and unequal'sshould be treated unequally (7)” When resources are limited itis necessary to define certain circumstances under which a person may not be consideredequally (3). Utilitarianism: Priorities must be set to obtain the best outcomes for the greatest amount of people

Strengths:•There are many other non-controllable factors that may contribute to the disease, making it impossible to allocate the organ fairly(1,2).•The argument of utilitarianism in undermined as a characteristic of this principle is impartiality: each person’s welfare counts equal.Weaknesses: •Argued that people who participate in risky health behavior are contributing to their illness therefore could be considered as unequal according to the principles of justice (3,8,9).•To whom should we do good? Giving an organ to a patient with an unhealthy life-style means someone else will miss out(9).

Juliette Roex, Emma Lane, Kate Seagrim, Ned Young, Jaya Lindsay

organ transplants lifestyle

factors

Demand

Supply

Who should receive the organ?

There is a personal right to engage in risky behaviour and any life involves some health-risk, therefore life-style factors should not influence the prioritisation of organ transplants.

FOR AGAINST

Respect for autonomy: Patient has the right to make their own choices, even if they are harmful.

Universality: If one person is allowed to risk their health by engaging in a dangerous sport, then other people should be allowed to risk their health by smoking (4).

Utilitarianism: A transplant

could do more good in a patient

who does not undertake risky

behavior (5).

Deontology: The doctor’s duty is to treat patients, irrespective of the cause of illness.

Respect for Autonomy: Patient has a right to make decisions for themselvesNon-Maleficence: Refusing to treat a patient based on past lifestyle choices could cause harm

Utilitarianism: Judgments by the

doctor may result in greater good for a greater number of

people

Thorough research has revealed strong arguments on both sides of this debate. We believe the arguments against the prioritisation of organ transplants are more strongly supported by a wide range of ethical principles. Deontology supports that it is not the doctor’s role to choose who lives and dies, but to treat each individual patient equally. Autonomy validates one’s choice to live and enjoy life’s risks, as well as a patient’s right to request treatment. To deny a patient treatment due to their lifestyle choices is not in the patient’s best interests and causes them harm, thus opposing the principals of beneficence and non-maleficence. We believe a system for prioritisation of organ transplants should based on other factors, such as the likelihood of benefit for the patient and the urgency of treatment.

Egalitarianism

Group Members

References1.Sharkey KS, Gillam L. Should patients with self inflicted illness receive lower priority in access to health care resources? Mapping out the debate. Journal of Medical Ethics vol. 36 (2010): 661-6652.Ho D, When Good Organs Go To Bad People. Bioethics vol.22 no.2 (2008): 77-833.Beauchamp TL, Childress JF. Principles of Biomedical Ethics, Oxford University Press (2001) 5th edn. 4.Brudney D. Are Alcoholics Less Deserving of Liver Transplants? Hasting Centre Report vol. 37 no.1 (2007): 41-475.McMaster P. Transplantation for alcoholic liver disease in an era of organ shortage. The Lancet vol.335 (2000): 424-4256.Council on Ethical and Judicial Affairs, American Medical Association. Ethical Considerations in the Allocation of Organs and Other Scarce Medical Resources Among Patients. Archive of Internal Medicine vol.155 (1995): 29-407.Rogers WA, Braunack-Mayer. Practical ethics for General Practice, Oxford University Press (2009) 2nd edn. 8. Kluge E. Drawing the ethical line between organ transplantation and lifestyle abuse. Canadian Medical Association Journal vol.150 no.5 (1994): 745-69. Thornton V. Who gets the liver transplant? The use of responsibility as a tie breaker. Journal of Medical Ethics vol. 35 (2009)