Question

Scenarios:

A. Al, a reformed alcoholic, is 42 years old with failing kidneys. He has been having hemodialysis 3 days/week for 3 years. He has had to deal with 5 failed accesses; is about to lose his recently revised access. Without kidney transplantation, he will die within the year. He is a father of 3 children, unemployed, and on welfare (Medi-Cal).

B. Sam, a well-known and respected Neurosurgeon, is a 50-year-old with failing kidneys, as well. Unlike Al, Sam currently drinks in excess (some might label him as an alcoholic). Sam is single, gainfully employed and is loved by his colleagues and friends.

1. Why SAM should get kidney out of these 2 men?

2. 5 debate able points?

3. should get a kidney transplant should a kidney with the same blood and tissue type become available and they both match?

AL team (42 yrs. old) with failing kidney	Sam Team (50 yrs. Old) with failing kidney
Alcoholic	Alcoholic
Hemodialysis 3 days/ week for 3 years
Without kidney: he will die within the year has 3 children unemployed welfare (medi-cal)	Single Gainfully employed Loved by his colleagues and friends.

Answer 1

1.Sam should get kidney transplant because though he is alcoholic, he can explained and helped to understand its harmful effects and stop using it.

But this is not in the case of Al who thinks alcohol is good and it will provide cure. Even if he gets a transplant the rate of success is very low because of his reformed alcoholic behaviour making him to drink again that it will cure him.

2.Some of the debatable points are

• As both are alcoholic both has to be provided equal chance to get a transplant
• Keeping in the mind of age factor a patient in his early 40 should be given priority than a patient who is in his 50s
• The ethics of being non maleficience is violated her by not selecting him for the transplantation fit individual
• Sam who has a good survival rate after alcohol rehabilitative programs can lead a normal life if transplantation is done

3.According to the criteria the medical emergency, survival benefits has to be considered .Here the first patient cannot be offered because there is a contraindication if they dont cover the expense under an insurance. This simply makes them ineligible to get a transplant and make Sam to get a transplant because of his insurance or financial stability to meet after transplant.