Ethical Issues with Medical Funded Organ Transplants Using Medicare

A continuing problem exists in trying to close the gap between the supply and demand of procured organs in the United States. An increase in the amount of transplant operations performed has risen significantly over time. As a result, a new name is added to the national waiting list every 16 minutes (Duan, Gibbons, & Meltzer, 2000). It is estimated that about 100,000 individuals are on the national transplant waiting list at all times (Munson, 2012). Something needs to be done before these numbers get completely out of control. Despite the introduction of Gift of Life and many other educational efforts, the United

It was only a matter of time before a businessman in Virginia saw a way to profit from the success of transplantation. In 1983 H. Barry Jacobs announced the opening of a new exchange through which competent adults could buy and sell organs. His failing was in his decision to use needy immigrants as the source of the organs (Pence 36). As a result Congress, passed the National Organ Transplant Act (Public Law 98-507) in 1984, which prohibited the sale of human organs and violators would be subjected to fines and imprisonment (“Donation Details”).

In 1983 Dr H Barry Jacobs, a physician from Virginia, whose medical license had been revoked after a conviction for Medicare mail-fraud, founded International Kidney Exchange, Ltd. He sent a brochure to 7,500 American hospitals offering to broker contracts between patients with end-stage-renal-disease and persons willing to sell one kidney. His enterprise never got off the ground, but Dr Jacobs did spark an ethical debate that resulted in hearings before a congressional committee headed by Albert Gore, Jr., then a representative from the state of Tennessee. The offensive proposal for kidney sales led to the National Organ Transplant Act to become law in

The successful use of cadaver organs was made possible by the development of immunosuppressive drugs like cyclosporine. The practice of utilizing immunosuppressive drugs has led to a decrease of transplant failure-rejection of a new organ- by the recipient’s own immune system (Kaserman, 2007). As research continues to look for new ways to decrease organ rejection rates, the majority of recipients take immunosuppressive drugs and will need to do so indefinitely (Ehlers, 2002). Kaserman states that as the transplant industry grew, a need for guidelines became apparent and hence requested that Congress create a governing body (2007).

Not only is the dilemma of inmates receiving organ transplants affecting physicians, but it affects all citizens equally, as well. It costs taxpayers ten and hundreds of thousands to millions of dollars to provide one prisoner with a transplant operation (“Organ transplants for,” 2011). “Efforts to ensure prisoner rights have compromised the lives of law-abiding taxpayers who are the state’s main source of income when it comes to paying for inmates’ medical bills” (Robinson).

The American Medical Association’s Code of Ethics mandates that doctors tell their patients if their tissue samples are going to be used in research or will possibly lead to profits. Some post Nuremberg codes, such as the Declaration of Helsinki and the Belmont Report, say consent is required. These are not laws but ethical codes, but many institutions choose to get consent regardless. Issues on privacy are also resolved; the Health Insurance Portability and Accountability Act of 1996 prevents a privacy violation like the one that happened to the Lacks’ from occurring. Under the Common Rule, samples cannot be named using the donor’s initials, but instead by code numbers. The NIH has strict guidelines on tissue research, and it is illegal to sell tissues for medical treatments or transplants. In fact, under the Common Rule, people can even take their tissues out of research anytime they want to. There are many laws that protect patients and their rights, therefore new laws on tissue rights are unnecessary because there are already many proficient laws in

Recent medical advances have greatly enhanced the ability to successfully transplant organs and tissue. Forty-five years ago the first successful kidney transplant was performed in the United States, followed twenty years later by the first heart transplant. Statistics from the United Network for Organ Sharing (ONOS) indicate that in 1998 a total of 20,961 transplants were performed in the United States. Although the number of transplants has risen sharply in recent years, the demand for organs far outweighs the supply. To date, more than 65,000 people are on the national organ transplant waiting list and about 4,000 of them will die this year- about 11 every day- while waiting for a chance to extend their life through organ donation

The need for organ donations creates another ethical dilemma for Emergency Room Physicians. “Obtaining organs from emergency room patients has long been considered off-limits in the United States because of ethical and logistical concerns” (Stein, 2010). The shortage of organs available for transplant has caused many patients die while waiting. A pilot project from the federal government “has begun promoting an alternative that involves surgeons taking organs, within minutes, from patients whose hearts have stopped beating but who have not been declared brain-dead” (Stein, 2010). “The Uniform Determination of Death Act

Available became controversial. While the question of the dialysis machine is still controversial, the health system was caught in another ethical dilemma regarding organ transplantation. Organ transplantation is closely linked to the issue of cleanliness because patients with kidney failure can get an organ transplant as an alternative to hemodialysis. The issue is complicated by the fact Medicare is financed by organ transplant, and there are those who believe that the distribution of rare transplant is not right. There are thousands of terminal patients whose lives can be saved by organ transplantation, but there are no formulas of work that can be used to determine which of the thousands of patients will be given priority. It is left to the discretion of medical officers to decide who is worth saving. The ability to keep someone alive by replacing one or more of their major organs is a splendid achievement of medicine of the 20th century.

The participants of the IPT were chosen for their expertise, years of experience, certification, and passion for the patient-centered challenge. All the participants work in transplant administration. None of these individuals divide their time between the hospital and transplant administration. Too, they only see transplant patients in the in-patient and out-patient setting. The IPT members are as follows with their credentials, education, experience, expertise: PA-C, MPAS, Transplant Physician Extender, 10 ½ years as a physician assistant, 8 years as a transplant physician assistant; one transplant coordinator, RN, CCTN, 7 ½ years as a nurse, 2 years as a transplant coordinator, 3 years as a certified transplant nurse; MS, RDN, LD, CNSC, Transplant Nutrition Specialist, Nutritionist, 24 years as a dietician, 13 years as certified nutrition support clinician,

Organ transplantation is a term that most people are familiar with. When a person develops the need for a new organ either due to an accident or disease, they receive a transplant, right? No, that 's not always right. When a person needs a new organ, they usually face a long term struggle that they may never see the end of, at least while they are alive. The demand for transplant organs is a challenging problem that many people are working to solve. Countries all over the world face the organ shortage epidemic, and they all have different laws regarding what can be done to solve it. However, no country has been able to create a successful plan without causing moral and ethical dilemmas.

This paper will discuss the National Organ Transplant Act of 1984. It will address the public need of the time and really see what was happening that congress felt that this was a needed piece of legislation. Along with the public’s need we will address the policy’s solution. Were we will see what the intended purpose of this act involved and see just how the government planned to help. It will also look at the some of the difficulties that this specific act faced then and now. We will also look into the effectiveness of this policy. Looking at what it has helped, where it has fallen short.

Kidney transplants are the fastest growing surgical procedure that the world is in need of today. Throughout the globe, there are an estimated 2.8 million people that are currently in need of a kidney. Patients in need of kidney transplants are often placed on dialysis (a long term prevention for kidney failure). The sufferable acts of dialysis alone, can lead people to do irrational things. In their desperation, they often try to find ways to help prolong the life expectancy of their loved ones on dialysis. The problem lies in the amount of surgeries

One organ donor can save or improve up to fifty lives. Kidneys, hearts, lungs, livers, and other major organs have been applicable for organ transplants. Doctors performed the first procedure of this kind in the mid-1950s and since sustained many lives, earning the common name a “gift of life.” These surgeries have led to many innovative procedures that can solve problems that once seemed insoluble. Medical advancements, such as transplants, are ethical and necessary for promoting the well-being of society and saving lives.

Unlike other companies, IT mismanagement in health care companies can cost individuals their lives, and in Kaiser’s case many plaintiffs seeking damages against the company believe the errors surrounding the Kaiser Transplant Center have done just that. At the outset of the transition, Kaiser mailed potential kidney recipients consent forms but did not offer specific directions about what to do with the forms. Many patients failed to respond to the letter, unsure of how to handle it, and others returned the forms to the wrong entity. Other patients were unable to correct inaccurate information, and as a result, UNOS was not able to approve those patients for inclusion on Kaiser’s repopulated kidney wait list. Despite all of the IT mishaps, the medical aspect of the transplant program was quite successful. All 56 transplant recipients in the first full year of business were still living one year later, which is considered to be strong evidence of high quality. But as the organizational woes continued to mount, Kaiser was forced to shut the program down in 2006, absorbing heavy losses and incurring what figures to be considerable legal expenses. Kaiser paid a $ 2 million fine to be levied by the California Department of Managed Health Care (DMHC) for the various state and federal regulations it failed to adhere to in its attempt to set up a transplant program. Kaiser was