Defunding Organ Transplants: A Utilitarian Perspective

This article, even more than the 9/11 fund, seems to me to be largely dependent on society’s views about distributive justice, whether these views follow an egalitarian, a libertarian, or a utilitarian model. I tend to agree with Christina and Dave (I found myself reasoning through the case in a very similar way as both of them did) that, in this case, a utilitarian model is the best solution. I strongly disagree with the libertarian view that it would be the individual’s responsibility to pay for their own care, and it shouldn’t be a burden to the taxpayers. I think this type of thinking fosters a system that helps the rich, hurts the poor, and eliminates the middle class. On the contrary, an egalitarian model would only be feasible if the government had money to cover transplants without taking away from other needed healthcare expenses, which it doesn’t. This leaves me with only the utilitarian model.

I don’t know if people have read or seen news coverage of the nationwide “tea party” (TEA standing for Taxed Enough Already) demonstrations that were taking place today to protest what many view as excessive government taxing and spending. This attitude is, and has always been, prevalent in our society, especially in parts of the nation like Arizona that are adamantly opposed to large federal government. People often demand more and better services from the government, but are angry when their taxes increase in order to pay for these services. Even now, when many people claim to support reforming our health care system (which would almost certainly raise costs initially), they do not want to see the cost increase reflected in taxes (at least not within their own tax bracket). While aspects of this class have made me more cynical of our political system and the people in it, other cases like this have given me great respect for our government officials, as well as made me realize more than ever that these are jobs I would like to avoid for myself at all costs. It must be horribly frustrating to have limited funds and have to pick and choose whom you neglect within your community, and be viewed either way by some people as a heartless killer.

While this is certainly a difficult case to discuss because it is absolutely awful to think of refusing help to anyone who so desperately needs it, I think that the legislators are justified in their decision not to cover extremely costly treatments at the expense of offering less costly care to a greater segment of the population. Speaking of cost alone, I think this is the clear, though decidedly imperfect, solution to the problem. However, I think the utility in the non-transplant care outweighs that for transplants in other ways as well. The article focused quite a bit on the greater risk to transplant patients, to the point that some may even consider these operations experimental. The example of the individual who was provided with care and still died—in a less humane way no less—was probably a rare case but still a powerful example in illustrating the complexities of the problem, especially when risk is taken into account. However, even if the person lives, I think the quality of life they would enjoy after the operation should be taken into account when calculating its utility. The task force in a 1984 study found that the costs of the operation itself are relatively minor, but the majority of the money spent comes from “post-operative hospitalization and the frequent need to rehospitalize transplant patients to treat various complications. These are very common (averaging more than one per case in most reports on the literature). They include rejection episodes, complications from the operation itself, and infections that develop [as a result of the drugs they must take]” (317). Descriptions such as this lead me to believe that it is not only the cost of money that is too high to pay in this case at the expense of other needed care, but the benefit may not be as great for the individuals helped. Many other conditions can be treated for much less money and raise the standard of living of the patient to a much healthier and happier existence than it sounds like the transplants often do.