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final project Health rights - Joanne Nguyen Health Rights...

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Joanne Nguyen Health Rights and Responsibilities April 15, 2011 Describe and evaluate the ethical issues involved in Medicare-funded organ transplants. When the dialysis machine was discovered in 1960s , there were hopes that renal failure patients would get a life prolonging care . For renal failure patients it was a matter of life and death and everyone was willing to pay the amount no matter what to get to the dialyzed . Soon ,it became a controversial issue when it was realized that the demand was outstripping supply and equal distribution of the few dialysis machines available became controversial . While the issue of dialysis machine is still controversial , our health care system has been caught in another ethical dilemma regarding organ transplant . Organ transplant is closely tied to the issue of dialysis since renal failure patients can get organ transplant as an alternative to dialysis . The issue has been complicated by the fact Medicare has been funding organ transplant and there are those who feel that allocation of the scarce transplant is not fair . There are thousands of terminally ill patient whose life can be saved by organ transplant but there is no any working formula that can be used to determine who among the thousand patients will be given priority . It is left to the discretion of the medical officers to decide who is worth saving . The ability to keep someone alive by replacing one or more of their major organs is an astounding achievement of 20th-century medicine. Unfortunately, the current supply of transplant organs is much lower than the need or demand for them, which means that thousands of people die every year in the U.S. alone for lack of a replacement organ.
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In 1965, Title XVIII of the Social Security Act created Medicare under the principle of generosity. This title was to interject actively to the health and well-being of "all Americans aged 65 or older ... As long as health care services to low-income children deprived of parental support, the elderly, their caretaker relatives, the blind, and individuals with disabilities" (7, 8 p. 15198). Since its comprehension, Medicare has functioned with a authoritarian method taking decisions on what the Centers for Medicare & Medicaid Services (CMS) considered 'reasonable and necessary'. In 2007, The Secretary of the Department of Health and Human Services signed the 42 CFR Parts 405, 482, 488, and 498 otherwise known as 'Medicare Program; Hospital Conditions of Participation: Requirements for Approval and Re-Approval of Transplant Centers To Perform Organ Transplants' giving Medicare accountability for the quality of care that the patient received during transplants (4). This act placed Medicare in a authoritarian position where CMS command the policy to follow concerning transplant centers participation with Medicare. If the center fails to meet any requirements, there will be no waiver available to continue functioning as a Medicare provider.
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