Liver Transplantation

F.C. is a 54-year-old man with a history of chronic heavy alcohol use. He has frequent bouts of gastrointestinal bleeding for which he has been hospitalized on six separate occasions over the years. He continues to drink and exhibits most of the common manifestations of alcoholic cirrhosis. He was recently hit by a car and was hospitalized for a broken leg. He appeared to be under the influence of alcohol at the time of the accident and had a blood alcohol level of 0.18. F.C.’s family reports that his mental functioning has deteriorated significantly over the past few months.

In today’s medical field there is a profuse amount of room for ethical questioning concerning any procedure performed by a medical professional. According to the book Law & Ethics for Medical Careers, by Karen Judson and Carlene Harrison, ethics is defined as the standards of behavior, developed as a result of one’s concept of right and wrong (Judson, & Harrison, 2010). With that in mind, organ transplants for inmates has become a subject in which many people are asking questions as to whether it is morally right or wrong.

One of the areas that is currently affecting the United States is the ethical issue of organ transplant allocation. Since the first single lung transplant in 1983 and then the first double lung transplant in 1986 there have been thousands of people who have lived because of the surgery. One must examine, evaluate, and apply the four ethical principles to Organ transplant allocation to look at the ethical issues involved. Once must look at the fact that not every patient who would benefit from a transplant will receive one in time

Cohen and Benjamin assert that alcoholics should not be categorically excluded from access to liver transplantation. They argue that alcoholism is a disease and not a choice, and end stage liver damage requiring transplantation is a consequence of this disease. Furthermore, they argue that even if alcoholism is a choice, medicine should not incorporate moral judgments in the considerations of treatment decisions for the patient. They support this reasoning through three arguments: 1) it is impractical and almost impossible to make distinctions on morality, 2) the voluntariness condition to establish responsibility cannot be met, and 3) the implications and consequences of such system would be undesirable. Although these arguments are logical, they overlook certain details that question their applicability in liver transplantation cases.

Liver Allocation is an ethical dilemma for healthcare providers and patients. An article published in the American Journal of Critical-Care Nurses entitled “The Power of The Liver Transplant Waiting List: A Case Presentation” discusses a 60 year old woman with cirrhosis was placed on the liver transplant list under the category “status 7”. Status 7 is an inactive state and are considered unsuitable to receive transplant surgery. Liver allocation is done by an organization called the United Network for Organ Sharing (UNOS), and the way they rank patients to receive a transplant is by a Model End Staged Liver Disease (MELD). It is scored from 6 to 40, and those with a high scores are the ones to receive a liver transplant (Hansen, Yan, and Rosenkranz,

I am passionate about scientific developments and how these advancements will help shape the future, with man-made organs being a specific area of interest. Having researched the damage suffered by the liver due to alcohol abuse, I was astonished at the fact that there presently aren’t any effective treatments as a solution to this widespread problem. The need for liver transplants are greater now than ever and to meet our society’s growing demand, researchers must

In this society, organ transplant surgery has been perfected to where no risk is present. However, organs still have a high demand with low supply. In addition, the only people eligible to receive organs are those who came to their ailment at no fault of their own. In other words, they did not smoke, drink, or eat in manners that caused their diseased organs. The people who donate organs have to be perfectly healthy as well to eliminate unhealthy organs for donation.

One maybe how safe is this organ? Since the organ comes from a drug user is it a possibility that the organ itself could go through withdrawal symptoms? How would this affect the organ receiving patient? The National Institute on Drug Abuse informs the public that “street heroin often contains toxic contaminants or additives that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage to vital organs,” (Drug Facts: Heroin, 2014). The article by Seelye concludes that this is a safe process since there are rigorous testing and cleaning processes that take place before the actual transplant. Between the years of two thousand and six to two thousand and fifteen only two hundred and forty-nine hundred of one hundred seventy-four thousand and three eighty-eight, however only seventy-one of the two hundred and forty-nine perished due to the infected organ (Seelye, 2016). As a result of this process the resolution of this debate would benefit from a Kantian view. Since the rightness or wrongness in not the focus here. Instead the focus is the duty to mankind regardless of the whether one considers it right or wrong. However, Utilitarianism could also be used since, “we should choose as right action that which will promote the greatest happiness for the greatest number of people,” (Van Camp, 2014). In the end this decision of accepting a high risk organ is that of the patient after education and risk factors have been discussed with their healthcare provider. If I had to justify lawful organ donation from drug users, I would choose the Utilitarian and Kant Theory as my

(Furlov, B. Paskus, L.) Mental Health is of the highest concern along with the following:

Concerning reformed alcoholics, however, the ethical perspective is not as clear. Firstly, one must ask if a liver transplant would be successful and whether alcoholics have a shorter life expectancy than non-alcoholics. Currently, there is no compelling evidence that the transplant would not be successful or that alcoholics have shorter life expectancies. Morally, however, one could argue that a non-alcoholic should receive priority for a new liver, since he or she did not intentionally harm his/her organ. This begs the question: does an alcoholic choose to drink? If the answer is yes, then society can blame him for his cirrhosis. But, if the answer is no, then he is a victim of what is called the “disease concept of alcoholism” (Alhoff, 2005). The “disease

The foundation for a Drug Free World (2017) outlines the effects of binge drinking for an individual, including drowsiness, vomiting, and liver disease. Valley Sleep Centre (2016) suggests that alcohol causes drowsiness, due to alcohol’s sedative effect (substance that relieves anxiety and helps you fall asleep). On the other hand, New Health Advisor (2014) exclaims that vomiting is caused by the excessive consumption of alcohol, and it is the reaction to get rid of the extreme amount of alcohol in the body’s system. Alcoholic cirrhosis, a type of liver disease is considered by Patient (2015) to be when the liver loses its capability to function efficiently, and is caused by around 10 years of heavy

In 2002, the Model for End Stage Liver Disease (MELD) system for liver allocation was implemented and it resulted in lower waiting list death rates among recipients without changing 1-year graft and patient survival (19, 20), including those > 65 years (21) in comparison to the pre-MELD era. However, functional status and long-term clinical outcomes among older liver transplant recipients in the MELD era are unclear.

Available became controversial. While the question of the dialysis machine is still controversial, the health system was caught in another ethical dilemma regarding organ transplantation. Organ transplantation is closely linked to the issue of cleanliness because patients with kidney failure can get an organ transplant as an alternative to hemodialysis. The issue is complicated by the fact Medicare is financed by organ transplant, and there are those who believe that the distribution of rare transplant is not right. There are thousands of terminal patients whose lives can be saved by organ transplantation, but there are no formulas of work that can be used to determine which of the thousands of patients will be given priority. It is left to the discretion of medical officers to decide who is worth saving. The ability to keep someone alive by replacing one or more of their major organs is a splendid achievement of medicine of the 20th century.

Therefore, the provision of organ transplant is not restricted to inmates. Generally, societies have, under the best of conditions, a middling track record when it comes to evaluating the value of the incarcerated population. In relation to this is that the society believes that since the incarcerated population has taken so much from the society through their act which is

Alcohol has no beneficial attributes on a person’s health. Alcohol can have several harmful effects on human organs. Some organs in the human body that are damaged by alcohol consumption are the brain, kidneys, and liver. The human liver is the one organ that suffers the most damage. As stated in an article published by the National Institute on Alcohol Abuse and Alcoholism, “Because the liver is the chief organ responsible for metabolizing alcohol, it is especially vulnerable to alcohol – related injury” (NIAAA, 2005). Regular use of alcohol can lead to alcoholic liver disease (ALD). The severity of ALD can vary based on several different factors. Some of these factors include gender, age, the amount consumed, and how often alcohol is used. “ALD includes three conditions: fatty liver, alcoholic hepatitis and cirrhosis” (Alcohol Alert, 2005).