Influences of Health Care; The Issue Of Transplantation

The 20th century has brought significant revolutionary advances into the sphere of health care. The causes of infectious diseases were thoroughly studied, there were new vaccines and pharmaceuticals developed, which enabled doctors overcome such diseases, which were initially considered not curable. Innovations and development of new medical technologies accelerated a lot of important processes in health care, provided new options for treatment and prevention of diseases. “Between 1991 and 2003, for example, the number of medical device patents per year doubled, and the biotechnology patents tripled over roughly the same time. Increasingly, discoveries in the biological sciences are being applied toward the development of medicines and treatments targeted to refined subsets of patients to better address genetic or life circumstances”. (Edwards,  Davies, & Edwards, 2009, p. 38). Organ transplantation is one of the most challenging and controversial innovations in the sphere of health care. The principle of this process is based on the movement of one organ from one body to another body; this is usually done with the aim of replacing of a damaged or missing organ. Different organs of human bodies could be transplanted, including liver, kidney, heart, lungs, intestine, etc. The most commonly transplanted remain the kidneys, then comes the liver and the heart. Organ donors could be living people, as well as dead people. Organs are taken with tissues, however tissues unlike organs could be stored for a period of several years. For the first time successful organ transplantation took place in 1954. Transplantation is an utterly complex medical procedure, on the one hand this is a great step forward in medicine and real opportunity to save human lives and on the other hand transplantation causes a lot of debates and ethical issues, as it could also be studied in socio-economic context, where the main problem is organ trafficking.

Every day people all over the world die while waiting for their chance for organ transplantation. These deaths are really tragic, as it is known that there was a chance to save their lives. This is practically a kind of a choice, who gets the second chance and remains alive and who has to die. Certainly these factors cause a lot of pressure, as there is a need to increase the supplies of organs for transplantation. “And if transplant centers were to relax their standards to include more people—such as the those who lack insurance, have severe intellectual disabilities, older persons, prisoners, illegal aliens, and foreigners who cannot get transplants in their own countries—then the lists of those waiting could easily triple or quadruple.” (Edwards,  Davies, & Edwards, 2009, p. 42). Policymakers would be forced to reconsider their standards and procedures in order to provide more possibilities for people to donate their organs. Such changes would also cause controversies and ethical issues, as the question, whether to provide the available organs for those who are more in need or to those, who have the financial opportunities, still would remain acute, the question whether it is ethically correct to pay officially for donation of organs still remains unsolved.

This is evident that the main task of policymakers is to work out such a system, which would be fair and just for all participants of the process. This system should be transparent, the supplies of donated organs should be correctly organized and controlled. These are theoretical aspects, but they were not transformed into practical ones yet. Most of the questions about fairness and justice remain unsolved and there is a long list of considerations and conditions, which need to be met in order to perform transplantation. Among them are the following in America for example:

  • patients without insurance would not be accepted by transplant centers
  • patients over 75 are usually not considered
  • the number of foreigners is limited, etc.

The sphere of health care, as well as any other, can not remain static, it continues its development and there are new rules and regulations added. In 2010 the Patient Protection and Affordable Care Act was passed. This was an utterly important document for insurance coverage of people, who had not enough money. It was expected to help more than 16 million of people to use the Medicaid Program and around 16 million people get the insurance covered by their employers. Thus this Act is considered to be a serious step in upgrading the system of private insurance. Still it would also bring changes to public sector. “The cost of health care reform will be borne disproportionately by Medicare, which faces nearly $500 billion in cuts to be identified by a new independent board.” (Haughom, 2016, p. 2). These processes are luckily to have impact also upon transplantation. “Transplant providers, including transplant centers and physicians/surgeons need to lead this movement, drawing on our experience providing comprehensive multidisciplinary care under global budgets with publically reported outcomes.” (Haughom, 2016, p. 2).

The last couple of years brought a lot of debates about the health reform and the possibility of contradictions between that level of health care, which American citizens expect to receive and the level, which they are actually paying for. In this situation it was not easy to consider effective solution to the problem of better supply of organs for transplantation for those patients, who were in need. The United Network for Organ Sharing (UNOS) accepted an evidence-based process in order to cope with this ethical issue with the main aim of making the available resources used with the highest efficiency. The fact that the system was not always able to provide the best possible matches and this resulted in discarding of the donor kidneys, was also considered by UNOS. One of the suggestions in this sphere was to use the practice of “age matching”, which would allow using the available donor kidney to the best of their potential. There is no reason to give to young patients much older kidneys, as this would lead to numerous repeated operations in the future, because these patients could live longer, than their donated organs.  At the same time in cases, when young organs were donated to older patients, it was evident that the potential of these organs was not used to its highest extent. The UNOS made the proposition to use the new system of matching, which would allow using the potential of the organs and their functions rationally. Certainly this new system was supposed to consider not only the age of patients, but numerous other factors, which were vitally important. “Under the new proposal, kidneys which offer the lowest risk of transplant failure would be offered first to those local transplant candidates projected to have the longest post-transplant survival.  Other donor kidneys would be made available first to transplant candidates who are within 15 years (older or younger) of the age of the donor organ.” (Haughom, 2016, p. 3). UNOS made the calculations and concluded that application of this new system could help to increase the number of the lives saved up to 5000-15000 annually. At the same time this new system could allow to reduce the number of wasted kidneys.

One of the major impacts upon health care in the sphere of organ transplantation is certainly related to ethical concerns. The major objects of ethical consideration are the two key aspects – the source of organs and the method of their obtaining along with the notions of distributive justice. Taking organs from live people is considered to be one of the most controversial topics in organ transplantation. “The World Health Organization argues that transplantation promote health, but the notion of “transplantation tourism” has the potential to violate human rights or exploit the poor, to have unintended health consequences, and to provide unequal access to services, all of which ultimately may cause harm. Thus WHO called to ban compensated organ transplanting and asked member states to protect the most vulnerable from transplant tourism and organ trade.” (Zients, 2016, p. 2). Another aspect, which is widely debated, is the official trade of organs, whether it could be really beneficial for both sides, under the condition that the seller of the organ is fully aware of what he is doing and of possible consequences of his donation. It should be secured that such process would not be a violation of the Universal Declaration of Human Rights. There are also enough controversies in relation to organ donation for dead people.

Overall, transplantation of organs is without any doubts a serious breakthrough in the sphere of medical care starting from the 20th century; there are lot ethical and practical issues, which are related to organ transplantation, which still need thorough consideration and implementation of the newly developed systems and approaches. This process could be asimplified under the condition of application of evidence-based practice, which would allow medical professionals and their patients cooperate in making decisions and improving of the delivery of medical care for the patients. Evidence –based practice had serious impact upon health care due to its contribution to reduction of costs, improvement of quality of the care provided and research done. Organ transplantation is an important medical innovation, which could be really helpful in frames of evidence-based research in saving of numerous lives and providing the chances for organs receipts for longer and healthier lives. It is important to mention such external influences as physician-patient relationship, better solution of ethical issues and better medical decisions with the help of evidence –based research.

References:

Edwards, M., Davies, M., & Edwards, A. (2009, April). What are the external influences on information exchange and shared decision-making in healthcare consultations: A meta- synthesis of the literature. Patient Education and Counseling, 75 (1), 37-52.

 Haughom, J. (2016). 5 Reasons the Practice of Evidence-Based Medicine Is a Hot Topic. Retrieved from https://www.healthcatalyst.com/preventable-medical-errors-future-calling

Kolnsberg, Heather R. (2003). “An economic study: Should we sell human organs?”. International Journal of Social Economics. Emerald. 30 (10): 1049–1069

Zients, J. (2016). Saving Lives and Improving Health Care through Innovation in Organ Donations and Transplants. Retrieved from https://www.whitehouse.gov/blog/2016/04/01/saving-lives-and-improving-health-care-through-innovation-organ-donations-and

The terms offer and acceptance. (2016, May 17). Retrieved from

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"The terms offer and acceptance." freeessays.club, 17 May 2016.

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freeessays.club (2016) The terms offer and acceptance [Online].
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"The terms offer and acceptance." freeessays.club, 17 May 2016

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"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 29, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: March 29, 2024]

"The terms offer and acceptance." freeessays.club, 17 May 2016

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