course material

1. Analyzing an ethical dilemma. You are transplant nurse coordinator,
thinking
Analyzing an ethical dilemma.You are transplant nurse coordinator, thinking about two
patients who are being evaluated for placement on the kidney transplant waiting list. One
patient is a 40-yr-old African American schoolteacher. She is married and has two children.
The other patient is a 22-yr-old unemployed white man. He misses three or four dialysis
treatments per month and does not take his antihypertensive medications
consistently.Points to consider:• The foundation of this conflict resides in the Constitution,
in which the founders made education a free public resource and ignored health care as a
right. Health care then became a privilege, a resource to be obtained by persons with the
funds to pay for it.• It took almost 200 years for health entitlement programs to be
developed. Medicare is a federally administrated program. Individuals covered by Medicare
are protected by Constitutional laws prohibiting discrimination based on race, gender,
religion, and ethnic background.• Medicaid is a federally sponsored program jointly
administered by the various states. The states have the right to set coverage eligibility and
limits but may not violate an individual’s constitutionally protected rights against
discrimination.• It is highly unlikely that the standard prohibitions against discrimination
will change, but it is possible that definitions of unhealthy behavior such as substance
abuse, alcoholism, smoking, and obesity may be used to screen out candidates.• Nurses are
concerned about social justice because of their health advocacy role. Today the situation is
immensely more complex because of the cost and availability of care.Address the questions
below:Which ethical principles and values apply to this case; which ethical principles are in
conflict?What which of the patients should receive the next available kidney transplant?
Defend your answer using the steps of the decision-making model. Address each level of the
decision-making model. Identify other information that might help you make a
decision.Assignment ExpectationsLength: 1500 words