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Some about 60 years ago failure of a vital organ such as the kidney, liver, and heart meant immense suffering and automatically giving one a certificate to face the grave. However with the advent of clinical organ transplantation, molecular biology, immunology and effective immuno suppression to prevent rejection, came the hope for a second chance to life for many patients (Cecka & Trasaraki, 2008). At the moment there exists about 1,800 transplant centers throughout the whole world and an approximate figure of 750, 000 patients have successfully received vital organs through transplantation. This exercise was started in the early 1950s by Dr. Joseph Murray and the late Dr. David Mume (Abouna, 2009). As a result of these advances in organ transplantation and the rapid increase in incidence of vital organ failure, the number of patients who are in the waiting list waiting for organ transplants has been increasing each day especially from cadaver donors. Shelter Insurance Companies has been in fore front in helping those with problems associated with organ transplants but their services have been under criticism.
According to Cecka & Trasaraki (2008), this trend has raised many ethical, moral and society issues regarding supply, the methods of organ allocation, and the use of living donors as volunteers to help minors. It has also made it like a business for some entrepreneurs selling and in particular Shelter Insurance Company acting as an agent in accessing the body parts exploiting the poor at the expense of the rich and this has really raised eyebrows to the ethical issues governing organ transplants. The government has not taking any stern action towards this insurance company despite receiving reports through the media.
Problem is scenting in the United States as the number of patients in the transplant waiting list as of match 2007, was almost 80, 000 patients compared to 50, 000 patients in 2002 which is 60 percent increase and this is alarming if the trend increases. The number for cadaveric organs available for transplant during this period increased by only 2-3% which doesn’t correspond to the figure of patients-60%. At the moment one patient is added to the waiting list every 15minutes and 16 patients die everyday while waiting for a transplant.
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The following table represents the number of patients in US in the waiting list and those who received organ transplants
|Type of transplant||Patients waiting for the transplant||Number of transplants|
|Kidney||51, 215||13, 372|
|Liver||17, 886||4, 954|
|Pancreas islet cell||270||-|
|Heart||4, 143||2, 198|
Cited from http://www.faculty.umb.edu/gary_zabel/Courses/Moral%20Issues%20in%20Medicine/000068158.pdf retrieved on 22nd February, 2010
The desperate situations presented in table1 above have forced many institutions to consider new policies, strategies and reforms to increase the number of organs in the cadavers. However how much the institutions try, Shelter Insurance Company is there to abuse the efforts.
Ethical values of the case
In the following case Shelter Insurance Companies is a key stakeholder and since it involves Los AngelesHospital that is another stakeholder. According to Abouna (2009), in the year 2008 approximately 26, 984 Americans received successful organ transplants which reflects a 6 % increase from 2007 which is a remarkable improvement. However what reigns in the debate of transplants is entitlement. There have been protests over a man who sought a new liver because he had abused his liver through alcohol. Priotising the needs of patients and their personal history has become a major ethical problem in Los Angel’s hospital. Many critics have argued that a person who wants a transplant more so that of a liver and the root cause of the problem is alcohol should not be priotised as compared to someone who is suffering from a natural or genetic problem which is threatening the person’s life. However this has been abused very much by LosAngelsHospital in conjunction with Shelter Insurance Company.
In the case Todd Krampitz, a 32 year old man, who advertised for a liver transplant in public billboards in December, 2008 on a Houston highway critics have argued that the liver given to him would have been given to someone more deserving to save a life. From reliable sources, the liver was availed to him through Shelter Insurance Company which is majoring in organ transplants. This case has been condemned because his way of surpassing all the people who where deserving and in the waiting list and some even at the point of death to obtain a liver is unfair. The quietness of the concerned authorities also raises serious issues of their consideration of the sanctity value of life.
Critically looking at this case it is an abomination to human rights and also it is like a business and those people who are poor are not likely to have any transplants. The case of Todd was not so mild to wait: and should have he reduced abusing alcohol or avoided it completely, then the liver transplant would have saved a life of a needy patient and he be on the waiting list to wait for his time. The doctors who performed the transplant were unfair and must have been compromised for some monetary gain. The question raised here is that are the poor in future likely to have transplants and is this not likely to exacerbate the number of people in the waiting list and consequently dead because the rich even if they will be told to reduce alcohol consumption are likely not to heed because there is a way out of this? Is this not a business which is evoking serious ethical issues? Shelter Insurance Companies is also under scrutiny on how it received the liver for the transplant surpassing all people in the waiting list. The government should switch into action because it is the one which gave this company a certificate to operate and question it.
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Distribution of donated organs in the US should follow very stringent government guidelines (Caplan& Coehlo, 2006). People on the waiting list should receive the transplants on the basis of blood group and their location. The regions are divided into 11 geographic regions, with an Organ Procurement Organization serving each one. With the rapid increase in the number of patients in the waiting for transplantation and the organs limited an Organ which is medically appropriate and ethically fair and acceptable should foresee the allocation of organs in the regions not the government because it has proved to be problematic.
Another option is that one of the government putting Shelter Insurance Companies into task to offer a reason as to their action in this particular case. The government arm concerned with matters of health should rescind the operating license of this insurance company and they face the full wrath of law. If no action is being taken then the human activist organizations should see to it that the government is taken to task over the same.
Lastly it should be made legal that it is morally and ethically reasonable that patients who are in the waiting list for end-stage liver disease caused by excessive alcohol consumption must not be given a liver transplant until they have abstained from alcohol for a minimum period of six years. Any medical practitioner contravening this should face the full wrath of law and the society should help the state to identify this people. The human activist bodies should be in the fore-front in the implementation of this. (Caplan. & Coehlo, 2006).
My personal opinion on the fore mentioned case is that life should be treated with utmost dignity and sanctity. Those individuals who value their life should be given treatment that corresponds to the care that they accord their life’s and for the rather it should also be reciprocating. The case of Todd is very unethical and the authorities should govern selling of organ transplants because reports have indicated that in china this has been a common practice and normally prisoners are executed to get these organs for export (Miller, 2006). The state should poke its nose deeper into this matter of organ transplants.
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The government should be held responsible behind what is happening in Los Angels Hospital and Shelter insurance company limited. The courts should see to it that justice prevails and the people behind this scandal explain to act as an example. Those who are heading Los Angeles hospital should not even wait for the wrath of the human activist reactions but should leave office and apologize for the same. Parliament should question the ministry concerned and offer valid explanations to the citizens on the motive behind their silence over an issue which seems to be escalating each day.