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Alcoholics and Liver Disease

Alcoholics and Liver Disease - Fernandez 1 April Fernandez...

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Fernandez 1 April Fernandez Professor Blair Philosophy 7 5 March 2008 Alcoholics and Liver Disease Two articles, one written by two MD’s and the other by two college philosophy professors, discuss alcoholics, liver disease, and the fairness in which liver transplants should be distributed. For the MD’s they believe that a sort of discrimination should occur in liver transplants for reasons of their own, while the two philosophy professors believe that equality for liver transplants needs to happen. Both have their opinions on the matter of patients with alcohol- related end-stage liver disease (ARESLD) in comparison with end-stage liver disease (ESLD) and who should be given higher priority to receive the transplant. The question is, who has a stronger case? If one destroys his or her own liver by drinking heavily and is diagnosed with ARESLD, is he or she equally eligible with those with ESLD to receive a liver transplant? In the eyes of two MD’s, Alvin H. Moss and Mark Siegler, the answer is no. Moss and Siegler believe that the circumstances of liver transplantation differ from other lifesaving therapies in three respects. The first is that liver transplantation uses a nonrenewable scarce resource, a donor liver. Secondly, the allocation decisions for heart transplantation differ from liver transplantation in determining a cause for end-stage heart disease and those with a history of alcoholism are usually rejected from heart transplant programs. Thirdly, it is an expensive technology that has become a target of cost containment in health care. 1 Due to the circumstance that surround liver transplantation, Moss and Siegler believe that patients with ARESLD should be given the opportunity to have a
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Fernandez 2 transplant because everyone should be given that chance, but they should be placed lower on the list in comparison to those with ESLD. Moss and Siegler do not dispute the fact that alcoholism is a disease, but they believe it to be a “chronic disease, for which treatment is available and effective.” 2 People can be treated for alcoholism through many treatments. Take for example Alcoholics Anonymous, which is “the largest organization of recovering alcoholics in the world, as the most important component of their therapy.” Moss and Siegler stated in their article that in order to successfully treat alcoholism: “the patient must accept his or her diagnosis and must assume responsibility for treatment.” 3 Since ARESLD comes from ten to twenty years of alcohol consumption, the more one drinks and the more heavily it is done, the more at risk a person is to getting it. Due to the
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