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Mr. Krampitz's case

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The most challenging issue in healthcare provision is how to allocate the ever scarce but valuable resources. It is therefore critical to set standards by which these scarce and valuable resources are allocated. However, it often becomes challenging to set these standards. Additionally, the bypassing of the mechanisms of setting these standards is a contentious issue. One of these scarce and valuable resources is organ transplants or grafts which have to be donated by other humans or obtained through overly difficult means (Maddox, 1998). A 32-year old Todd Krampitz of Houston, Texas found an effective way to cut in line for an organ transplant and battled with liver cancer by the help of a donated liver (Sullivan, 2004).

A courageous family donated the liver of their loved one who had died to Krampitz. On 13th August 2004, Krampitz underwent a successful surgical operation and received the liver transplant although he undermined the system and acted unethically by obtaining the liver transplant by cutting in line (Sullivan, 2004). Although there were 17,000 people waiting for liver transplant according to the database maintained by the United Network for Organ Sharing in Richmond, Krampitz cut in line and never minded other patients who desperately needed the liver transplant than him. Some of the patients, according to Sullivan (2004) were from his own home place in Texas but Krampitz and his doctor knowingly went against the national system that ensures fairness in organ benefit.

It was unethical for Krampitz to obtain a liver directly from a family according to the organ distribution system which was established in 1986 (Sullivan, 2004). The system dictates that organs are to be given to people desperately wanting them and not to any person who can afford them (Maddox, 1998). The system uses various criteria to determine the right person to benefit from the available organ. These include blood type, medical urgency and the probability of survival. Krampitz did not qualify for the liver since he was not nearing death (Sullivan, 2004). However, there seems not to have been clear communication between the doctor who conducted the surgery and Krampitz. The blame seems to be on the “gag rules” which have been embraced by most HMOs and the US Healthcare which favored minimal restrictions. There is therefore a recent debate to have all doctors practice clear and open communication with their patients (Managed Care Magazine, 1996).

There seems to be several ethical issues surrounding organ allocation as one of the scarcest medical resource (Maddox, 1998). There questions on fair and equitable organ allocation, criteria for allocation and who to be responsible to maintain the list of those who desperately need the organs touch the line of ethical thinking (Moon, 2002). It is important to observe ethical principles in the allocation of organs to those who truly and critically deserve them so as to save lives. However, the need for long-term survival should also be considered (Moon, 2002). A clear record of all those requiring organs is critical to ensure long-term survival is regarded. At the same time, the records will ensure that no organ is allocated that does not match with the blood type of the patients. This mistake of not matching the blood type can easily be made and lead to graft rejection.

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