Principle of Transplant Allocation - Research Paper Example

? Ethical Health Care Issues - Transplant Allocation Transplant allocation is one of the most ethically discussed issue in medicine, this is usually based on the four ethical principles of biomedicine, these principles include respect for autonomy which entails respecting decision making capabilities of autonomous individuals to make rational and informed choices. Beneficence principle considers the benefits of treatment versus the costs and harm that will be caused by the treatment; the medical professional should act in such a way that it benefits the patient, the third principle is non-maleficence which states that a medical professional should no harm to a patient. The fourth principle is justice, which stipulates that costs, benefits and risks should be distributed equally among patients (Choi et al, 2012). This paper will look at transplant allocation from the four ethical principles in biomedicine. The first principle is respect for autonomy, which should be awarded to all affected individuals; this allows individuals to make rational decisions for them, which should be respected by other people. One of the greatest challenges in the four principles of biomedicine is the people who are covered by which principle, for instance, who are to be considered as adequately autonomous individual to make rational and independent decisions. Although it is widely acknowledged that babies cannot make rational decisions, the dilemma comes in the case of children who can talk and think for themselves, in the case of transplant allocation, the dilemma is when should a child’s decision to donate a kidney or any other organ be respected and implemented. In the question of autonomous another issues is a person who is emotionally attached to a recipient, to what extent can his or her decisions be considered independent bearing in mind the risks that are involved in the process. The other ethical principle that is generally accepted in the field of medicine is non-maleficience or the obligation of the medical experts not to do any harm to the patients. This obligation to do no harm to patients even when the principle of beneficence or ensuring patients benefit maximumly from the treatment is not accepted in some situations. For instance, an individual may refuse to donate a kidney, bone mallow or any other body organ to a patient but at the same time, he is also morally obliged not to do any harm to the patient initially. The principle that obliges the doctor not to do any harm to a person may seem to be violated when the doctor operates on a healthy person to remove an organ since it is bound to cause some harm such as the pain involved in the whole process, the risk of infection and also the risk of dying. Normally, in medical cases, the small discomfort and pain caused by medical operations is overridden by the expected benefits from the operation, this brings us to the principle of beneficence or the obligation of the doctor to help the patient benefit as much as possible from the operation. Since no medical operation to remove an organ or to transplant it in a person can be done without some little harm, the principle of non-maleficence is usually considered alongside the principle of beneficence to ensure the patient gets as much benefit as possible. In transplant allocation, an operation and its probability to cause harm to the donor or the recipient is considered if the operation can be reasonably expected to result in net medical benefit for the patient despite the risks that are associated with it (Voigt, Zimmerman, Katz & Rayhill, 2004). For instance if a patient is suffering from cancer of the kidney, the risks involved in transplant of the sick kidney are far outweighed by the benefits that the transplant will give him. However, if the cancer has spread to other parts of the body, the transplant operation is more likely to cause more harm than good therefore, it should not be carried out. In the case of a donor of an organ, the principle of beneficence does not apply since he or she takes all the risks involved in the medical operation to remove the organ without the corresponding medical benefits as the benefits goes to the person that will be transplanted with the organ. A major concern in discussion of harms and benefits in transplant allocation is in regard to the potential donor since operation to remove the organ involves great risks and inconvenience without the corresponding risk of benefiting. There is widespread agreement that a person is not morally obliged to donate an organ for the benefit of another, however, others argue that such gesture is morally admirable and represents a perfect example of altruism that goes beyond a person’s obligations. Even when an organ donor, being aware of the risks involved in an operation to remove an organ, willingly agrees to donate an organ, would still pose an ethical dilemma for the medical professionals. This is because since the time of Hippocrates, it has been the norm in the medical profession that doctors only operate on a patient if the operation is likely to produce net benefits for the patient, yet in this case, these benefits will be enjoyed by another person. The fourth principle that is considered in transplant allocation is justice, which is the obligation to treat conflicting claims in transplant allocation justly and with fairness especially in the face of scarce resources, respect for people’s rights and respect for morally acceptable regulations. A disagreement in this principle is as to what can be considered fair or just, although most of the people agree that it entails some aspect of treating people as equals but not necessarily equally. For instance, it would not be considered fair or just to allocate organs to the whole population that is need of them, however, there would be an aspect of justice when in considering who to allocate an organ to, the medical health practitioners considers individuals with equal needs. In the same measure, unequal individuals should also be treated unequally, for instance, individuals who do not need urgent operation, should not get urgent operation. In regard to right based fairness in organ allocation, individuals with equivalent rights should be treated as such while those with unequal rights should be treated unequally. For instance, individuals who have the right to be allocated organs first should be allocated first while those who should be allocated at different times should be allocated at different times. In addition, donors who have the same qualifications regarding their autonomy in making decisions should also be allowed to make their decisions without favouring any of them while those with different autonomy decision-making levels should be treated as such (Genda et al, 2013). Rights based justice also requires that transplant patients or donors should be given the opportunity to accept certain medications or reject them. The ethical issues that have surrounded transplant allocation can be minimised if not completely solved through the use of the four principles in biomedicine, which include respect for autonomy, non-malificence, beneficence and justice. These four principles are applicable to both the donors, the recipients and the medical practitioners involved in the transplant, however, different principles apply in different levels and some may not apply to certain groups, for instance, beneficence may not apply to donors. References Choi, Y., Lee, K. W., Hong, G., Kim, H., Park, M. S., Suh, S., ... & Suh, K. S. (2012). Status and Current Problems in the Allocation System for Pediatric Liver Transplantation in Korea. The Journal of the Korean Society for Transplantation, 26(3), 196-201. Genda, T., Ichida, T., Sakisaka, S., Sata, M., Tanaka, E., Inui, A. & Inomata, Y. (2013). Waiting list mortality of patients with primary biliary cirrhosis in the Japanese transplant allocation system. Journal of gastroenterology, 1-8. Voigt, M. D., Zimmerman, B., Katz, D. A., & Rayhill, S. C. (2004). New national liver transplant allocation policy: Is the regional review board process fair?. Liver transplantation, 10(5), 666-674. Read More