Medical Ethics PHIL 148 @ Binghamton University, Sum 11


Case Study: Health Care and Justice

Maddy is a smart, hardworking girl. She has not been given a lot of help with her schooling and has had to struggle on her own. On top of all that she must deal with the side effects and expenses of Crohns disease, a chronic inflammatory disease of the gastrointestinal tract. Due to her disease, Maddy must be careful not to overwork or overstress herself as it may induce flare ups. This is hard to do considering she must work while going to school and must worry about being able to pay all of her bills. After being malnourished and dehydrated, Maddy has suffered from two infection-causing kidney stones because she has not been able to pay for her Crohns medication. She refuses the required surgery because she does not have health insurance and she cannot pay out of pocket.

The health care system is not what it should be, but there are politicians and activists trying to correct that. Maddy deserves to have health care and she deserves to have the treatment that would allow her to continue school and continue to work. Now some, such as a utilitarian, may disagree with this view. The utilitarian may say that Maddy should not receive health care because that would be taking it away from another person who has a more serious condition. It is true Maddy’s condition is not life-threatening, however, that would mean that Maddy is being used as a means to an end. This idea goes against the very nature of deontology.

If the doctors wanted to help Maddy by doing the work pro bono, Kantian deontology would see that as the best decision because that would mean that the doctors are performing a duty out of good will. They are following the moral law by treating Maddy. Another approach would be to appeal to a health care committee to see if Maddy could receive health care based on their personal and professional recommendation. Rossian deontology would have a similar approach to this situation. Ross would argue that the physicians have a “prima facia” duty to help Maddy, either by doing the work pro bono or by giving her a large discount on the procedure.

There are a few duties that Ross states that would apply here: duty of beneficence – the duty to help others, duty of non-malficence – a duty to avoid harm to other people, and a duty of justice – a duty to make sure people get what they deserve. Anyone of these duties can take precedence over the other but all would agree that Maddy deserves treatment without the stress of paying for the costly procedure. The doctors have a duty of beneficence to help Maddy. They have a duty of non-malficence to prevent Maddy’s condition from getting worse. The large sector of health care cannot look at each case and decide who really deserves free medical care or not. If it did then I’m sure this controversy of our health care program would be alleviated much quicker. Maddy is someone who deserves medical care. She is a hardworking student that pays her own bills and is diagnosed with a serious and costly disease but for whatever reason she has not been provided with health care. Therefore, it is the doctor’s duty of justice to make sure she is treated, either by doing the work pro bono, giving her a large discount on the procedure or by appealing to some sort of health care committee to see that Maddy gets the health care she deserves.

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