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Biology LibreTexts

The Desperate Dozen: A Problem of Biomedical Resource Allocation

This page is a draft and is under active development. 

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The list below shows a dozen candidates waiting for a heart transplantation. Assume that on the average there is one transplantable heart per month for candidate pool.


Your Task: Rank the candidates in order for the next heart, which has just become available. Describe the ethical foundation upon which your priority selections are made and explain its application to each ranking you make.

 

Person & Age Critical Need Relative Immunology
“Match"
Resulting Quality
of Health
Estimated # of
yrs to Death
Ability to Pay Comment & Rank
Surgeon, 62

95

80 45 4 99  
Mechanic, 25 60 60 85 5 25  
Mother of six, 36 50 90 70 13 90  
Politician, 44 75 50 60 10 80  
Famous Singer, 30 80 80 70 25 92  
Writer, 56 60 95 60 15 40  
Criminal, 31 70 90 97 35 60  
Your Mother, 55 90 90 30 8 50  
Astronaut, 32 75 70 60 20 60  
Autistic Child, 14 60 80 75 18 75  
Scientist, 34 80 60 70 12 50  
You, - 75 80 50 4 45  
Evaluation scales 100 = Immediate
90 = 1 week
80 = 2 wks.
70 =1 month
60 =2 mths.
50 = 4 mths
100 = Perfect
90 = Excellent
80 = Very good
70 = Satisfactory
60 = Marginal
50 = Risky
90 = Marathon runner
80=Active
70=Normal
60=Ambulatory only
50=Disabled, weak
<40=Bedridden
  Number is % of costs patient can pay by self or
insurance
 

 

Further discussion

Would your rankings change if:
A) Mother of 6 was homeless, on Medicaid
B) Auto mechanic was a registered sex offender
C) Your mother has early Alzheimer’s symptoms
D) Politician has views that were different from your own
E) Research scientist specializes in immunology
F) Singer has donated thousands of dollars to charities

Adjust your ranks according to this new information. Use a different color to indicate changes made from your first list.

 

Final Task

Based on your tanks and discussion with your team, develop a unified ethical basis for making biomedical decisions about transplants with consideration to limited resources. Your plan should address how transplant committees should decide who gets hearts first and why some might be placed at the end of the line. You can write this as a paragraph or a bulleted list that shows how these decisions will be made.


The Desperate Dozen: A Problem of Biomedical Resource Allocation is shared under a not declared license and was authored, remixed, and/or curated by LibreTexts.

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