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Sharing is caring, or so some believe. Organ donation tends to be an opinionated subject. Ratios of supply and demand are greatly unequal, potentially due to fear or mistrust of the system’s process for donation and allocation. Some fears which prevent donation include ending treatment prematurely or improper use of donated organs. Choosing the appropriate candidate can be a daunting task. Complicating allocation is whether or not a prisoner should receive an organ transplant. When a transplant is deemed necessary for a convicted person, concern for justification arises.
Benefits and risks should be considered for the best utilization of the organ without regarding the person’s social status, such as incarceration. Ethical principles assist in ensuring nomination for the best candidate. The available organ along with the donor’s family deserve good stewardship from the appointer for proper use of their gift. A just decision should be high priority in effort to appropriately utilize the limited resource. Opting for the most suitable candidate, considerations should include the recipient’s chronic health issues and organ’s potential longevity; therefore, the incarcerated candidate is the best recipient for transplant of the available heart.
Narrowing from the “wait list” to a single recipient, consideration should lean toward the candidate with the least amount of chronic health issues. When presented with the decision between two cardiomyopathy cases, the healthier man is deemed the best option. The thirty-three year old incarcerated candidate has far less chronic concerns. Increased level of unhealthiness potentially complicates healing. Rejection is an additional complication to review.
While this manifestation is unpredictable, multiple ailments could increase the likelihood of rejection. Although the prisoner requires a heart transplant to overcome viral cardiomyopathy of unknown origin mild hypertension is his only secondary diagnosis. The alternate candidate, while in desperate need of a heart replacement, is overwhelmed with secondary diagnoses. The fifty-nine year old suffers severe ischemic cardiomyopathy. In addition to damage from two myocardial infarction episodes, he is burdened with hypertension, renal insufficiency, and coronary artery disease. Furthermore, history of alcoholism lends to the idea of unhealth within other systems for this candidate. Recovery with multiple issues would be a difficult and lengthy course.
Realizing the ethically sound choice extends justice to those in need. Matching an organ with a recipient holds a great amount of responsibility. Research for the ideal candidate should include weighing risks and benefits along with pros and cons. “Justice is the fair consideration of candidates and medical needs” (Butts & Rich, 2016, p. 232). Properly matching organs with candidates is overseen by the United Network for Organ Sharing (Butts & Rich, 2016). Allocators should uphold the good stewardship principle when matching donated organs with a recipient. A main concern ought to be providing the best potential for the organ. An unfortunate death occurred to furnish the available organ. Care should be taken to utilize the gift to its fullest potential.
Considering an available organ’s potential longevity falls under the medical utility ethical principle. The Organ Procurement and Transplantation Network encourages fair decisions in allocation by taking into account the expected survivability of patients and organs (Butts & Rich, 2016). Less chronic health diagnoses allow a transplanted organ to have a longer lifespan. Ideally, a younger candidate has more years ahead to utilize the organ. The recipient’s health record and life expectancy should be reviewed. “Waste occurs when need is not met as fully as it could be, and avoiding waste is important given the organ shortage” (Moorlock, Ives, Bramhall, & Draper, 2016, p. 291). The gift of an organ deserves the highest survivability chance to be granted. The limited supply causes allocation decisions to encompass a wide range of information. Relative waste is deemed as the difference between maximum benefit and actual benefit in which an organ provides (Moorlock et al., 2016). Minimizing waste increases the benefits of organ transplantation. Additionally, the general public places higher levels of trust in medical personnel when allocation is properly executed. As trust increases perhaps fears will dissipate, which results in a better supply of donors. Ethical allocation of an available organ is necessary for best utilization of the gift of life.
Reviewing information on the two candidates, a clear choice emerges. Despite the status of incarceration, this candidate portrays as a better fit for the available heart. Imprisonment status is trivial and should be set aside from the deciding criteria. Other areas serve greater importance in regard to allocating with good stewardship. Viral cardiomyopathy with mild hypertension is compared with ischemic cardiomyopathy battling sobriety, renal deficit, and arterial disease. One candidate is obviously dealing with a shorter list of medical issues. The available organ has a greater chance of long-term survival with this candidate. Responsible allocation points to the thirty-three year old man.
Information such as a health record should be gathered on a recipient to choose the appropriate transplant candidate for allotting the greatest survivability of an available organ. As previously discussed, the incarcerated candidate is the best match in this case for the heart transplant. Social status is less of a concern than chronic health status. The complication of rejection presents an uphill battle in itself. Polluting the situation with additional health problems decreases the chance for successful post-op recovery. Organ donation involves a life sacrificed to save another. Careful thought is necessary to serve both parties with justice.
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