Justice in Healthcare: Bedside Rationing

Justice in healthcare is a substantial part of ethics in medicine, here we will cover some of the distinctive aspects of justice-based concerns and some basic ethics language to help wade through these interesting ethical issues.

READ: this short piece by Dr. Jonsen and Dr. Edwards goes into some detail about resource allocation in the medical setting.

Now start to apply what you’ve learned. This reading provides some preliminary perspectives on a case of transplant tourism. This is just one among many forms of distributive justice where we see an inclination to ration at the bedside.

READ: Satel and Aronson. (2008). “Transplant Tourism: Treating Patients when They Return to the U.S.”, Virtual Mentor, American Medical Association Journal of Ethics. Volume 10, Number 5: 271-277.  

As you read CONSIDER:

  1. What does bedside rationing mean in this case?
  2. What is the central ethical question the physician faces in this case?
  3. What do you think should be done? Why?
  4. How does this case affect your vision of collective efforts towards social justice?

WATCH: When thinking about justice, it is important to explore the perspectives of all stakeholders and consider the procedures through which they interact. In the case of transplant tourism, this means knowing where organs can come from as well as who seeks them out. See this short video from BBC News that portrays one family’s experience.

 

 


For further reading (not required)…

There are several impressive documentaries on transplant tourism, here is one from the UK that is slightly older (2004) but provides extensive insight into the perspectives of various stakeholders including patients, families, and transplant surgeons on multiple sides of the debate: The Transplant Trade. There is another newer documentary that investigates China’s illegal organ trade called Human Harvest, which can be accessed through the library here.