The hospital ethics committee was discussing an important and urgent case. A donor heart had become available, but an extremely rare thing had happened. Two heart-transplant candidates in the hospital were both matches for the donor heart. One patient was known to the committee as Mr. X, the other as Ms. Y.
For someone with heart failure, Mr. X had been on the transplant waiting list a long time. He had been waiting one year and was near death. Ms. Y had just been placed on the list and could be sustained with medication for quite some time, possibly until another heart became available. The answer seemed obvious-give the heart to Mr. X.
A number of the members of the committee did not agree with this answer. They argued that time on the transplant list should be only one factor considered. They saw a problem in Mr. X's medical record.
Mr. X was 64 years old and had suffered from a heart condition for years. He had had two angioplasties and two bypass operations to correct a blockage of the heart's blood vessels. The problem seen by some committee members was that Mr. X still smoked, ate fatty foods, and was very overweight. After each procedure, doctors had warned Mr. X that he must change his life-style, and that if he didn't, his condition would worsen. He never stopped smoking, however, and never changed his diet. He said it was too hard.
Research has proven that smoking and high cholesterol are risk factors for heart problems. Blockage of the coronary arteries is directly attributed to these two factors. Treatments such as angioplasty (opening the blood vessels by passing a tube into the arteries) and bypass surgery (connecting new blood vessels that go around the clogged ones) can correct the problem, but they are not a total cure. To avoid further problems, patients must control their diet, stop smoking, and alleviate stress. This, of course, is not easy. Mr. X appeared not even to try.
The heart was about to be airlifted to the hospital. The committee had to make their decision very soon.
What would you do?
This situation is a tough situation morally because most would want to give the heart to Ms.Y because Mr. X is so careless with his health. This, however, is not the legally correct thing to do since he has been on the donor list for so long and she was just placed on it, he should get the donor heart. I believe that since it is the doctors responsibility to aid the patient who has been on the list for longer, then the donor heart needs to go to Mr.X. This is a case of morality versus legality and I think in this case, legality is the most important.
ReplyDeleteThis situation is very hard and difficult. I think in this situation you have to go more towards morality rather than legality. Mr. X obviously did not care enough about his health to stop what was causing him to have these issues. While on the other hand it seems like Ms. Y has done nothing wrong and this is happening to her. Even though Mr. X has been waiting longer he has done nothing to help his case. If he would get the new heart he would go back to his old ways, he even said that "it was too hard". To me that would be a waste of a healthy heart that someone like Ms. Y could be using.
ReplyDeleteI disagree, I think the heart should be given to Mr. X. I say this because he was on the list first. Also, we are judging him just on his lifestyle choices. He most likely has a family behind him waiting with hope that there will be a heart that matches.
DeleteThis a very hard decision. At first I thought Mr. X for sure, but as I kept reading and hearing how careless Mr. X is, the decision started to become harder and harder. After thinking about it for a while, I would say you would have to do what is legally right and give the heart to Mr. X. I say this because Mr. X has been on the list longer. Even though he does have all these problems, it would not be right to just skip him, especially when he is near death. Imagine if you were family with Mr. X. You would be devastated if you found out there was a heart available for him but they gave it to someone else who just got on the waiting list.
ReplyDeleteI understand where your reasoning comes from and it makes logical sense, but should we ignore the efforts of Ms. Y in this case as well as where does the best outcome lye? Either way this is a difficult question and I see the reason behind your response.
DeleteThis decision is one that needs to be determined by the the best legal decision. While I say this I also think that the decision of the outcome of the patient would be. If Mt. X has not given any reason or has shown any effort to make a change n his life style what is the chance that he will value the opportunity the has been presented with. Ms. Y on the other hand has has not shown a reason to doubt her responsibility in taking care of herself. While this may be the case the Ms. Y is in significantly better shape and can sustain life for much longer that Mr. Y. Either way this is a difficult decision and any answer is going to have potential consequences.
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