In a perfect world all needs could be met with unlimited supplies of products and services, yet we do not live in a perfect world. What is present is a state of inequality where many are denied access to necessary services and though we endeavor to provide as many as we can with affordable services our resources are being stretched to the limit as is. In matters of life or death these limitations are all the more evident especially in cases where organ transplants are necessary.
The fact is that there are just not enough organs to go around based on the number of cases that need them. Hard choices need to be made yet these choices need to factor in not only to whom the organs can go to but rather who would benefit the most from them. on the one hand we have the choice of framing our decision based on an adherence to a particular set of rules in that individuals who are “ahead” so to speak on the organ donation list should be the first to receive organs.
Justifying the Decision Making Process
Such a method of decision making would be the most fair in terms of distributing the limited supply of organs yet it must be questioned whether such a method is truly the most effective approach.
Many within the current list for organ transplants have advanced ages and may not live long while others are on the list due to conditions that they had deliberately inflicted on themselves (i.e. excessive smoking and drinking leading to cancer of the lungs and liver failure. In such cases it must be questioned whether it is moral to pick such individuals over those who are in need of organs through no fault of their own.
There are also cases where the possibility of survival is so low that conducting an organ transplant could actually be considered a waste since it is likely that such individuals will die anyway. Individuals who have many years yet to live and those who have no evidence of prior substance abuse would be able to live fuller lives and be less likely to squander the gift of life as compared to others who will most likely squander such a precious and limited gift.
It must also be questioned which choice would result in the greatest degree of happiness. For individuals that have shown evidence of living longer and substance free lives the potential for generating greater degrees of happiness is that much more likelier as compared to individuals that are old or are more prone to self destructive behavior.
New Hospital Policy
Taking this into consideration it will now be the policy of the hospital to eschew the normal organ transplant list in favor of prioritizing patients with higher life expectancies, few self-destructive behaviors and above all are young enough to fully enjoy the benefits of the organ.
While it can be considered unfair in the case of those who are “ahead of the list” it must be noted that not all individuals can be deemed as being “worthy” for organ transplants. The hospital must make decisions in light of limited supply and as such it is necessary to implement selective and purposeful decisions that take into account utilitarianism and deontological ethics in order to do what is right for our patients.
What must be understood is that these decisions are made in light of limited supply and as such must factor in the potential each individual possesses. Without such decision processes in place the organ donation process will continue to be mired in ill- fated consequences in which the ethics of specific organ allocations will be questioned.