07 Oct The first five of General Moral Considerations- pr
The first five of General Moral Considerations- producing benefits; avoiding, preventing, and removing harms; utility; distributive justice/procedural justice; and respect of autonomous choices and actions. For this assignment, you are to explore the ethical issue – MEDICAL ERRORS, then discuss how each of the five GMC’s listed above may or may not apply. Identify any current and/or future political, legal or economic challenges, as they relate to the ethics of public health practice and health care delivery. Hypothesize potential solutions to the ethical challenges through utilization of appropriate GMC’s. (3-5 pages) I have attached examples to help direct and guide you. EXAMPLE PAPER: According to the text, Essentials of Public Health Ethics, the basis of public health ethics is set upon a collection of general moral considerations (Bernheim, 2015). The first five general moral considerations are producing benefits; avoiding, preventing, and removing harms; utility; distributive justice/procedural justice; and respect of autonomous choices and actions (Bernheim, 2015). These general moral considerations can be associated with the ethical issue of organ translocation. First to consider is the general moral consideration of producing benefits in regards to organ translocation. When dealing with organ translocation producing benefits applies to the process and procedure of the matter. At the time an organ becomes available, a recipient will have been chosen from the recipient list based upon the criteria of that particular list. These criteria would ensure that an individual would be chosen so that the greatest possible benefits are produced. For example the criteria for an organ recipient list may exclude a smoker from receiving an organ because it may be presumed that a smoker would not have as beneficial an outcome as a nonsmoker. Next to examine is the general consideration of avoiding, preventing, and removing harms in regards to organ translocation. When it comes to the actual harvesting of organs needed for organ transplantation, certain considerations must be taken to ensure that more harm is not being done to the individual donating organs. Many may argue that doctors are impatient to remove organs from viable donors, but the truth is certain criteria are in place to safeguard that no further harm takes place to said donor. According to Medscape News and Perspective, the said donor sometimes referred to as the trauma patient is carefully looked after to ensure further harm (Finger, 2016). Medscape describes the treatment to prevent harm to the donor saying, “Treatment of the trauma patient continues in the manner deemed optimal for the injuries sustained, until the determination of brain death. After this determination, treatment is directed at maintenance of organ function, while familial consent for organ donation is sought or until mechanical support is withdrawn.” (Finger, 2016). This confirms that an organ donor would not be subjected to any unnecessary harm due to the need of their organs for donation. Also to explore is the concept of producing the maximum balance of benefits over harms and other costs in relation to organ translocation. This concept is also commonly referred to as utility. The criteria related to receiving an organ relates to utility in its objective to donate an organ to an individual that will receive the maximum benefits of such an organ. This goes back to the criteria of organ recipient lists and how priority is determined. An individual’s priority on an organ donor list is described by Medscape saying, “Priority on each organ list is based upon several factors, including proximity to the donor, severity of illness, length of time on the waiting list, and special circumstances related to particular medical conditions.” (Finger, 2016). These parameters are currently in place to maximize utility of organ translocation. Subsequent to inspect is the general moral consideration of distributive justice/procedural justice in respect to organ translocation. Distributive justice deals with distribution of burdens and benefits in a fair manner, while procedural justice refers to assurance of public participation, including that of the affected parties (Bernheim, 2015). Distributive justice plays a role in organ translocation in the form of the organ recipient list. Again, the organ recipient lists ensure that all organs are allocated in fair manner based on many factors that play into receiving an organ. This list strives to guarantee that organs or given to those that would benefit the most from such an organ. Procedural justice also applies to organ translocation in the form of the organ recipient list and guidelines. This establishes strict guidelines that can’t be skirted around by doctors or medical professionals assuring a transparency of the organ translocation process. Last to consider is the application of respect of autonomous choices and actions when dealing with organ translocation. When the time comes for consent for organ donation, the revised Uniform Anatomical Gift Act of 1968 comes into action. After revision in 2006, the act lays out the consent for organ donation saying, “In its current form, this act reaffirms that if a donor has gifted organs, their wishes should be honored and the family need not give additional consent. It also expanded the list of people able to consent for organ or tissue donation if a potential donor has not registered their wishes before death.” (Finger, 2016). This act guarantees that a donors autonomous choice of organ donation be respected when it comes time for their organs to be donated, no matter the say of their loved ones or families. It must be noted that organ translocation, specifically the subject of organ donation, currently face legal challenges and issues in regards to consent. According to the British Journal of Anesthesia, in the United Kingdom consent for organ donation may be oral or written, and may be given before an individuals death or by a third party (friend/relative) (Price, 2012). Generally speaking, in the UK there is no requirement that consent be in writing for the removal or organs to occur (Price, 2012). All around the globe organ donor laws vary from evident given consent to ‘presumed consent’ (Price, 2012). So called ‘presumed consent’ better known as opt-out laws are described as, “…donation where there is no evidence of any objection from the deceased person before their death, but vary markedly in terms of whether relatives have an ultimate right of veto and the information that must be provided to relatives after the deceased’s death.” (Price, 2012). These opting out laws are beginning to become the majority and exist in nations such as Belgium (Price, 2012). Such opting out laws have been associated with increased cases of organ donation, however it is not to say that other factors may also be at play to influence such an outcome (Price, 2012). In cases or presumed consent, all a family must do is fail to object to the organ donation for the donation to take place (Price, 2012). Some may argue this saying, “A failure to object [to presumed consent] is no kind of consent at all.” (Price, 2012). The concept of presumed consent appears to many of its critics as a policy that does not embody a form of legitimate consent for organ donation (Price, 2012). Some have gone as far as to compare presumed consent to a form of stealing saying, “This in turn leads to allegations of ‘taking’ of organs by the State and an avoidance of any requirement for individual consent, which is potentially extremely damaging to the basis of trust, upon which a system of organ donation depends.” (Price, 2012). For these reasons, some have become opposed to presumed consent laws and deem them as unethical. To work towards an ethical and well-accepted means for organ donation, a certain solution may be considered. Such a solution would call for the regard of the general moral consideration of respect of autonomous choices and action. In order to properly respect the autonomous decision of the organ donor, there would be a need for clear and concise consent or objection. This could come in the form of a mandated consent. This could be accomplished by the means of a signed agreement that must either state the willingness to have ones organs donated or object the donation of ones organs (Price, 2012). In this case, there would be no question as to the individual’s standpoint on organ donation or whether their true choices would be honored at their time of death. Whereas with presumed consent in place an individuals organs are simply up for grabs if there is no one there to object for them. This type of consent has actually been implemented in numerous state jurisdictions in the United States where it has seen mentionable success (Price, 2012). For example, the state of Illinois has seen organ donation rise from 38% to a staggering 60% of the population (Price, 2012). With this solution in place an individual would have recorded their autonomous decision that would be respected after their death.
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