Medical Ethics PHIL 148 @ Binghamton University, Sum 11

27Jun/110

Debate Summary- Health Care & Justice

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The idea of whether administering limited medical resources out to patients on a first come, first serve basis is a very controversial one. It can be attested both ways very honorably. Here are a few reasons people have argued that this method of distributing resources is unfair. For one it can be argued that these are important medical resources and therefore should be distributed to those in need of it, not simply to those who are in line for it. Many of these individuals may not necessarily need them but simply want them. Medical resources should be treated with a higher regard, it is not a materialistic want, such as an iPod and for some it can be matter of life and death. The question of autonomy also came about in the form of challenging a person’s right to a limited resource simply because they were in line first. The moral and utilitarian thing to do in this case would be to honor a person’s need for a resource first before their want. It was also made clear that this is a situation in where inequality is unavoidable and if anything encouraged because some people have a higher need for the limited resource then others and therefore their need should be met first regardless to who came in line first. If hospitals treat these resources in any other way then unfairness is dealt to those with a more severe need then others. One may also find themselves arguing that instead of the method of first come, first serve, severity should be the deciding factor of resources. How severe a patients need is a more just way of distributing resources then going by a chronological protocol. A utilitarian would justify this entire argument by saying that giving at least minimal treatment to all is what is moral. Denying someone stitches for something as serious as a gunshot wound would be completely immoral if the reason was because that resource was already given to someone who came earlier then that patient when instead their need could have been satisfied without consumption of that limited resource.

Taking into account the several reasons that the first come, first serve method is not favored amongst people, there are also numerous reasons one may be pro this decision. For instance it can be said that a medical institutions duty is to provide care and resources necessary for good health out to its patients. However, some resources are limited and therefore a fair and orderly method is necessary to distribute these resources equally. It is up to physicians and practitioners under their Hippocratic Oath to perform at their best abilty to get a patient healthy and to look out for their well being first and utmost. It does not make sense for a doctor to simply not treat a patient that is currently under their care with the best medicine possible simply under the assumption that a future more severe case may come along. If that case never comes, then there is a loss of that limited resource along with complete dissatisfaction of treatment by both patient and doctor. This is a very un-utilitarian way of doing things because there is displeasure going around from all sides. Many feel that it is a hospitals duty to respect fairness and therefore respect a patients place in line, if you may, for receiving a resource for it is their right and they deserve the opportunity to be treated fairly. Another argument is that several resources are limited and have a short life span. If we want to put these resources to use in the most utilitarian and moral way possible then they should be distributed to those who come first to claim them. Doctors cannot be held back under the assumption that a more sever case may come along. The life span of the resource may simply dwindle away while the doctor waits for a fictional patient to come around while a real patient in need of their care is already present. Both for and against first come, first serve can be argued heavily. It is simply up to our health care system to determine who makes the more insightful assertion.

26Jun/110

Case Study Summary- Health Care & Justice

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Maddy is a 25-year-old woman who works and goes to school part time but unfortunately is plagued with Crohns disease.  This disease has also led to the development of two kidney stones; however, she denies any surgical procedure because of her inability to fund it.  The ethical perspectives all have something to say about this particular case.

Kantian deontology believes that some physicians should do whatever they can in their power to help Maddy out.  Whether it be by doing the work for free or by lowering the cost of the procedure, it still needs to get done in order to fulfill a duty.  Ross’ duty of beneficence also plays into this as well.  Essentially, doctors should be performing this out of the good of their hearts in order to make for a better world.  Maddy also has a prima facie duty of self-improvement and that duty is more vital than her duty towards anyone else’s inconvenience.  Utilitarianism suggests that we don’t waste resources on one individual.  The main premise here is whether helping Maddy out will be beneficial on a larger scale; is Maddy’s treatment going to positively affect the world.  The main agreement with utilitarianism is that by helping Maddy out, resources aren’t being used as they should be.  They are not being used efficiently and can be used on a bigger scale to help out more people; essentially, maximum utility of resources are not being attained.  In one aspect however, utilitarianism can be attained.  If Maddy were to receive this treatment and move on with her life, she would then be able to finish school and receive her master’s in the field of health care.  With this education under her belt, she would then be able to help out society.  So if looking at the situation from this point of view, a greater good can be attained.  In general, there is a difference between the present and the future.  In the present, utilitarianism would not agree since resources aren’t being used as efficiently as possible.  In the future, utilitarianism will agree since Maddy’s education can benefit society.

Virtue ethics would find some venue in order to have Maddy receive her procedure.  Her father could take her in to help her out with the bills.  Her friends could help her out financially with her medical expenses.  She could receive financial aid from the institution she is studying.  Maddy might be able to find another job that would give her some health benefits.  Since Maddy has invested so much time and effot and clearly isn’t a lazy individual, virtue ethics would side with Maddy and somehow enable her to receive the medical attention that she deserves.  Care ethics stresses the relationship that has been established between Maddy and her physician.  If the physician was abiding by the moral standards of care ethics, the physician would see to it at that Maddy is taken care of.  Whether the physician performs the procedure at a discounted rate due to her situation or whether he/she somehow enables her to receive some sort coverage for her medical expenses, the physician must do all in his/her power in order treat Maddy.  In the end, when all is said and done, the relationship between patient and physician is the most important part of care ethics, and the only way a healthy, trusting relationship can emerge is if the physician finds a way to perform the procedure on Maddy and see that she becomes healthy.

 

 

 

 

26Jun/110

News Article Summary- Health Care & Justice

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One article talks about a 59-year-old man who has been working as a delivery man for CoCa Cola for 17 years.  Unfortunately, an economic downturn caused him to lose his job along with all health insurance and benefits.  With carpal tunnel syndrome and arthritis afflicting him, he decides to rob a bank in order to go to prison and receive medical attention.  First of all, it is ridiculous to think that a man would rather give up his rights as a citizen of this country and perform such an act in order to obtain health care in prison.  It just shows how a good chunk of citizens are not being tended to properly in this country.  Some solutions to this problem would be different types of health care systems that are utilized in different countries in the world.  One suggestion is to follow Britain’s lead in giving all people some sort of basic health care, and from then on, people would pay as they go.  If they want additional services, they would have to pay for them; however, people will never be satisfied with just getting a minimum.  Any minimum still might not be considered to be good enough by the people.  Another alternative would be the health care system that is practiced in Canada in which a doctor is pre paid with a one time fee to cover patient’s care for a specified time.  Only problem with this is that the patient would be stuck with the doctor, and the doctor might not provide the best care since the patient is already locked in.  A bigger conflict that is addressed with this article is whether prisoners should receive health care or not.  Should they receive some sort of basic care?  Any sort of care is a burden on tax payers, essentially law-abiding citizens.  This article definitely brought some problems in providing health care that the country needs to address.

 

The second article talks about the different sort of health care systems that have been established in other countries.  A majority of people believe that the bundling system is the best one.  Since it makes all of the medical staff work together and efficiently, patients receive the best care that can be provided in the fast time possible.  It gets rid of unnecessary visits that just places more money in the doctors pockets for no reason.  Efficiency coupled with quality care push the bundling system to the most preferred by the class.  The readjust risks program which covers about 80 diseases restricts the care too much and allows for too many issues to arise.  If a disease is not on the list of “80,” problems can arise as to whether or not care should be continued.  The quality of care system places too many resources into the tracking of treatment and results.  That money could be better spent.  A final thought to think about is that no matter which health care is decided on, will everyone be completely satisfied?  Unfortunately, the answer is no.