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Unformatted text preview: Available Actions M icroallocation Nicholas Rescher, in his 1969 article, The Allocation of Exotic Medical Lifesaving Therapy (ELT) upholds social worth criteria as a necessary component in allocating ELTs. George J. Annas in his 1985 article, The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation rejects the use of social worth criteria as unfair and inequitable. Both authors attempt to specify criteria for the allocation of scarce medical resources. A. Nicholas Rescher The Allocation of Exotic Medical Lifesaving Therapy (April, 1969) Rescher argues on utilitarian grounds for a set of three criteria for the allocation of exotic lifesaving therapies (ELTs) such as organ transplants and kidney dialysis machines. 1. Reschers Argument P1.) That action should be selected, which leads to the greatest good for the greatest number (utilitarianism) P2.) In the context of the allocation of exotic life-saving therapies (ELTs), a system of organ allocation that upholds P1 will have the following features: 1. Criteria of inclusion used to nar row down initial pool of candidates a. Constituency- Choose persons living in and paying taxes in that particular constituency in which the hospital with the organ or life saving technology is located. b. Progress of Science- Choose persons who, in the opinion of the medical staff at the hospital, will further the progress of science. c. Prospect for Success- Chose those for whom the surgery is most likely to be successful. 2. Criteria of comparison used to narrow down pool with a case-by case comparison of candidates remaining after step 1. a. Relative likelihood of success of surgery Perform a case- by-case comparison between potential recipients to determine for whom the transplant is most likely to be successful. b. Life expectancy Attempt to determine how long the potential recipient will benefit from the transplant. c. Family role Assess the financial and psychological dependence of family members on the potential recipient. d. Potential Future Contributions to Society (utilitarian) Attempt to determine what future services the potential recipient will render to society. e. Past Services rendered to society Consider the past contributions the potential recipient has made to society. 3. Lottery approach- If more candidates still remain after utilizing the first two criteria, uses a randomized selection or lottery (P3) Any system of organ allocation that satisfies P1 ought to be adopted. Therefore, the system of organ allocation specified in P2 ought to be adopted. B. George Annas The Prostitute, the Playboy and the Poet: Rationing Schemes for Organ T ransplantation (1985) 1. Annas criticisms of four major approaches to organ allocation: 1. Market Allocation Organs are provided to those who can pay for them....
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- Fall '09