eTHICS mIDTERM 2 - o :TheStoryofChristine...

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ALLOCATING SCARE RESOURCES  o Bone Marrow Transplants for Advanced Breast Cancer: The Story of Christine  deMeurers (Alex London) - Background: - Christine deMeurers had stage 4 metastatic breast cancer, and was a mother of 2, had    husband, and was a teacher. She and her husband had health insurance, but  had purchased the    cheapest plan available Health Net.  - She and her family exhausted all standard therapies available, but there was a new  procedure    available (high dose chemotherapy with autologous bone  marrow transplant) that offered some         hope, although it had no proven benefit at the  time.  - Their insurance denied coverage for the procedure since it was “not uniformly accepted  as    proven and effective for the treatment of metastatic breast cancer.” - The doctor who was going to give the treatment also happened to be a member of their    insurance committee – conflict for the doctor between helping patient  and upholding the policy    he had a part in shaping.  - In the end, a third-party covered the costs (UCLA), and Christine had 4 disease-free  months    before succumbing to the cancer. - Issues illustrated by this case: - We embrace values of frugality and fiscal sensibility, which lead us to protest high  health care    costs. At the same time, we won’t accept any less than the  latest and most sophisticated    healthcare. - Should we, the government, or insurance pay for procedures of this nature? - Should we pay for procedures of unknown benefit when there are people struggling to  get    procedures of known benefit? - Those with the resources and ability to articulate their compelling cases can receive    access to these kinds of procedures while the less articulate  and less well-off cannot. - If we don’t draw the line on medical expenses here, where will we? - What makes a procedure considered experimental? - UCLA’s decisions - Looked like a caring, good decision - But, these resources could have been used on a less risk need of ours - Towards a more just system - Solution: If we give subscribers an active role in the formation of guidelines that govern  their    care (rather than deciding randomly what will be approved and why via  people with money    bringing their cases to court), insurance providers will  give their subscribers a stake in making    sure such guidelines are both fair and  effective. It will ensure people are treated as ends in    themselves and not as  mere means.
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- Christine’s insurance denied the HDC/ABMT procedure on the grounds that it was    experimental. They can make a strong case for this via the 
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