Ethical Dilemma in Medical Decision-Making, Exams of Nursing

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Memo – You Decide Brittany Lieber Dr. Nelson ETHC 445N September 2018

As the doctor in the situation with deciding which patient to receive the heart transplant, it is a very difficult decision. To decide if the fiftyfiveyearold man Jerry should receive the heart, his heart damage caused by steroid use before the effects of steroids were discovered. He is the father of three children and the sole provider for his family. Lisa, a twelveyearold female with a history of lifelong health issues that still will not survive long with the heart, but if she is the recipient her father will donate a much needed two million dollars to the hospital. Finally, Ozzy, a thirtyeightyearold homeless man with a history of abusing crackcocaine which caused his heart problems, without the transplant, Ozzy will not live the rest of the month, and he has stopped the drug use and is working as counselormentor for troubled teens. The three cases each have benefits to each receiving the heart and negatives to not receiving the heart. As the doctor, it is up to me to reasonably determine which patient receives the heart. Per the concepts of utilitarianism, as described by John Stuart Mill, utilitarianism decisions are made by assessing the quality and quantity of pleasures that will result from the choice. (Mill, 48). To apply this principle to the situation, the most people would benefit from Lisa to get the heart because the donation of two million dollars would benefit the hospital and therefore benefit the most people because the hospital treats so many people. Next, Ozzy would be the second choice because of his work at the youth center. He is relied upon and offers exclusive insight for the troubled youths, which can be a lot of youths visiting with him and becoming his mentees. His mentoring can keep kids healthy and working toward a successful life. Lastly, Jerry receiving the heart would benefit the smallest number of people, it would benefit his family, which is four people.

being the action of transplanting the heart, which is morally good because it benefits a family that will be on dire straits without the heart, and the final being the moral recognition of the transplant, it is saving a life. Not to say the others will not benefit from the heart, but the drawbacks with giving Lisa the heart are that as a doctor I may be ethically scrutinized, and be accused of “selling” the heart because I gave it to person that was going to give the hospital a gain, and make it seem like the donation of millions of dollars is a contingency for receiving the heart. Also, Lisa still has a poor prognosis even with the heart. In terms of Ozzy, as previously mentioned the potential for Ozzy to take back up with drugs will surely destroy his new heart and kill him very quickly, whereas Jerry will benefit for at possibly fifteen to twenty years with the new heart, and he has no drug abuse problems as of recently and he has a very good prognosis following the transplant. Jerry benefits from this decision because his family will be able to continue to function as is, if Jerry did not receive the heart and passes away, the family would have no way to fend for themselves and no source of income. This decision saves a family and this patient has the best prognosis after the procedure.

References Mill, J. S. (1991). Utilitarianism. Oxford: Oxford University Press. Kant, I. (2008). Grounding for the metaphysics of morals. Brantford, Ont.: W. Ross MacDonald School Resource Services Library.