Resolution for Heart Transplant Issue
Ok, Lead Surgeon, it is time to do what you do best! There is a lot at stake. The decision must be made almost immediately. Like all actions, you will need to write your decision into medical documentation before you begin. Yes, that means YOU! In the limited time before you would begin surgery, you need to consider the cases; the technical issues involved also, and write a Memorandum for the Record to document what decision you made and what considerations you included in your process. This will be on the record, so it needs to be thorough in case it needs to justify your actions at a later date.
You are the Lead Surgeon in a major hospital, and by virtue of your seniority you are also the key decision maker for transplant cases. Right now you have three people who are waiting and hoping for a suitable heart to become available. Your cell phone rings suddenly, and you are notified that a heart has become available-meaning that you need to make a quick yet sound decision about which patient will receive the heart and then schedule surgery for today.
Male 55 years old family man, mid level manage
Jerry, a father of 3 children and at the age of 55, is in the Ward awaiting a suitable heart for transplanting. His wife Joanie is a stay at home mother with no education beyond high school and no career. Jerry is the middle level manager at a carpet distributing business and 5 year short of his retirement eligibility. Jerry and Joanie have three teenage children aged 14, 16, and 19. The 19 year old is a sophomore at college; the 14 year old is mildly autistic, and the 16 year old is an astronaut wannabe. If Jerry gets the heart, his chances of living another 10-15 years are very high. His heart is damaged due to the use of steroids in his early 20s when he was involved with bodybuilding before the dangers of steroid use were fully known.
Female, 12 year old lifelong health issues
Lisa is one of those precocious girls – a doll-like girl at the edge of becoming a teenager. She reads voraciously and yet likes the activities of a younger girl playing with her Barbie Doll. She has suffered health issues all her life due to various viral infections and a lupus-like immune deficiency. Her heart was damaged during a nasty bout with pneumonia last year and actually stopped for a brief period. Her mother knew to begin CPR on her or she would have died there. Even with a transplant, her chances of surviving into her 20s are not good. She is the only child in the family, and they cannot bear more children. Her parents will do anything for her, and they have offered to donate $2 million to the hospital’s construction of specialized facilities if she can get a heart soon enough. Her father is also a noted oncologist working in the same hospital but in a different department.
Male, 38 year old homeless drug abuser
Ozzy is a single 38 year old man with no family. He has lived homeless and in shelters for at least a decade. He was brought to the Hospital through the work of a local charity that assists such men with no assets or insurance. His heart condition is due to continued abuse and overdosing of crack cocaine, and without a transplant he will not live out the month. In recent months, has become involved with troubled teens at a local homework and tutoring hangout, and he has provided the wisdom and insight that only an abuser can know about where life can go. He has signed a contract with the same charity that, if he gets the transplant, he will continue working at the after-school homework hangout as a counselor-mentor for at least one year after the transplant. With the transplant and successful staying off the drugs, he could live another 10 years – maybe more. Recidivism is a severe risk with his history of abuse, and if he returns to using crack he would quickly damage the new heart and die within month
Male 35 year old. Lisa’s dad, the oncologist
Dr. Jonathan Doe is Lisa’s father. He has offered the hospital $2 Million Dollars in exchange that his daughter gets the heart transplant. He is an up-and-coming oncologist in the same hospital. He is loyal and totally committed to Lisa; while not obnoxious and pushy, his presence is keenly felt around the professional community in the Hospital and there is a need for his $2 Million.
The “You Decide” assignment presents a difficult and painful dilemma, with you in an imagined professional role. Go through the You Decide presentation, make the decision it calls for, and compose a paper and presentation that explains your decision and your reasoning and justification for it.
You are called upon to make a painful medical decision and to explain it both orally and in writing. Who benefits from what you decided, who gets denied a needed benefit, and why? You will compose an official memorandum that will be kept for the record and could potentially be read not only by your Peer Review Committee, but also by those involved in charitable fundraising, which supports hospital development, as well as by others with financial interests in the decision.
You will see notice that there is time pressure in the simulated situation, so remember that you would not have the luxury to dawdle in the decision-making process, and as the decision-maker, you would not have the luxury of consulting a broad spectrum of advisors. It falls on you to decide!
Include in the document and presentation the utilitarian ethical philosophy of John Stuart Mill (from the lecture and audio for this week) and one other ethical philosopher of your choosing that we have studied to date, and use both of those philosophies to bolster your decision. This paper will be at least 2 pages and no more than 3 pages. Remember, both professional written form and potential audience, as well as tone when writing this sensitive memorandum.
Outside sources are not required, but if used, must be cited properly
Resolution for Heart Transplant Issue
As it might be per your information, our organization is currently faced with the situation of heart transplant case. We have three patients in waiting who are in need of the heart transplant surgery and all of them hold important positions to the organization, our stakeholders and their family including the entire community at large. We have only one heart at the moment and this has brought a dilemma on how the situation will be handled. The purpose of this memorandum is to help the society to understand the situation, the ethical dilemma and the ethical norms that are in the conflict, to elaborate the stakeholders that the dilemma will affect, to provide the alternative course of action that is will be taken and the best solution to the situation. The memorandum will also express my personal feelings to what should be done to deal with the situation and the conclusion.
The situation has three patients involved. First is Jerry, 55years old father of three. His heart was damaged due to steroids use when he was in his early 20s out of bodybuilding activities. We then have Lisa, a 12years old daughter to Dr. Joe. Nasty bout pneumonia damaged her heart last year which actually stopped for a brief period. Lastly we have Ozzy, a 38years old male whose heart condition was due to continued overdosing and abuse of crack cocaine.
When I decide to offer the heart to Jerry, him and his family will benefit, while on the other hand, Lisa’s father who is also an oncologists to this organization will be demoralized and resign from his job he will never have a child a gain . The organization will also lose $2 million that Dr. Joe had pledged to donate incase his daughter’s life is saved. Also, the local charity that brought Ozzy to the hospital will lose counselor-mentor to their local teens. Saving Ozzy’s life will benefit him his life and also the local charity, but on the other hand, Jerry’s family will suffer as he is the sole breadwinner with a career less wife plus three ambitious kids that totally depend on him. Lisa and his father will not still benefit as explained. When Lisa’s life is saved, she will benefit by having a chance to live another life. The organization will also benefit as it will have not risked losing its employer and also, it will get the $2 million from Dr. Joe.
The stakeholders in this dilemma are Jerry and his family, Lisa and her father, Ozzy, the local charity and organization. Jerry is the breadwinner to his family and a manager at carpet distributing business. The carpet distributing business organization will have its employee for next 5years or lose if he gets or don’t get a chance. Lisa’s parents will have a child if her life is saved or not have any child at all as they have no chance of bearing more children. Ozzy will have chance to live and the local charity will have a tutor to their teens if he lives, or will lose the tutor if he misses the chance. The organization will retain their oncologist and also get $2million donation from the Dr. or lose if Lisa’s life is not saved.
I recommend performing heart transplant surgery to Lisa as the best solution. Based on utilitarian ethical philosophy of John Stuart, it states that the action that maximizes utility is the best action (John, 2012, Williams et al., 2015). This is the option that has the most utility to the stakeholders. Lisa has chances of living next 20years if her life is saved. Her parents also will have some pride to have a child. The organization will not lose or frustrate its employer and I will also gain $2 million donations to hospital construction project. Giving heart to Ozzy might put the situation at the risk as he risks abusing again the drugs and definitely dying within a month, or he will live for maybe 10years. Jerry has only 5years to retire and less than 15years to live if he gets the chance. Ozzy and Jerry’s cases will not suffer utility consequences is they miss the heart transplant compared to Lisa.
I believe this was the best solution anybody else could have offered. I saw it most appropriate to go by the utilitarian principle which advices that the action taken should have results that have greatest good to the greatest number of people. I also considered the golden rule work ethics that advises to act in the way you expect others to act towards you.
To sum up, the purpose of this memorandum was to analyze
how to come up with the best solution to the dilemma of who to give a heart
transplant chance and who to deny. The body has clearly analyzed every case
with possible effects to all stakeholders. My suggested solution is to offer
heart transplant to Lisa as she stands to live the longest life compared to
Jerry and Ozzy. Her consideration will also bring the greatest utility benefits
to the stakeholders.
Mill, J. S. (2012). Utilitarianism. Dover Publications.
Williams, B., Moore, A. W., & Lear, J. (2015). Ethics and the limits of philosophy. London: Routledge.