Building the Foundation for Ethical Decisions

Assignment:

Analyzing an ethical dilemma.

You are transplant nursecoordinator, thinking about two patients who are being evaluated for placementon the kidney transplant waiting list. One patient is a 40-yr-old AfricanAmerican schoolteacher. She is married and has two children. The other patientis a 22-yr-old unemployed white man. He misses three or four dialysis treatmentsper month and does not take his antihypertensive medications consistently.

Points to consider:

 The foundation of this conflict resides in theConstitution, in which the founders made education a free public resource andignored health care as a right. Health care then became a privilege, a resourceto be obtained by persons with the funds to pay for it.

 It took almost 200years for health entitlementprograms to be developed. Medicare is a federally administrated program.Individuals covered by Medicare are protected by Constitutional lawsprohibiting discrimination based on race, gender, religion, and ethnicbackground.

 Medicaid is a federally sponsored program jointlyadministered by the various states. The states have the right to set coverageeligibility and limits but may not violate an individual’s constitutionallyprotected rights against discrimination.

 It is highly unlikely that the standard prohibitionsagainst discrimination will change, but it is possible that definitions ofunhealthy behavior such as substance abuse, alcoholism, smoking, and obesitymay be used to screen out candidates.

 Nurses are concerned about social justice because oftheir health advocacy role. Today the situation is immensely more complexbecause of the cost and availability of care.

Address the questions below:

1. Which ethical principles and values apply to this case; which ethical principles are in conflict?
2. Which one of the patients should receive the next available kidney transplant? Defend your answer using the steps of the decision-making model.
3. Address each level of the decision-making model. Identify other information that might help you make a decision.

Assignment Expectations

Write a1000-1500 word essay addressing each of the points/questions. Be sure tocompletely answer all the questions for each question. Support your ideas withat least three (3) citations in your essay. Make sure to reference thecitations using the APA writing style for the essay. The cover page andreference page do not count towards the minimum word amount. Review the rubriccriteria for this assignment.