Institutional Ethics and Economy

SCENARIO: Jeff Henderson is an 11-year-old boy living in your local community with his parents and his younger sister. Jeff has a rare disease which, while not immediately life-threatening, will become life-threatening as he ages. His disease requires ongoing treatment with a very expensive medicine. Although both his parents work, their employers do not offer health care insurance and the family cannot afford coverage. Jeff’s current treatment needs can be met by the local hospital. However, as he grows older and needs more frequent care, the local hospital is faced with ever-increasing demands on the pool of funds they use for indigent care. Jeff’s medicine is currently consuming almost half of the entire annual pool. The nearest hospital that can take on Jeff’s care and absorb the costs is 75 miles away. Transferring Jeff to that hospital will mean four 150-mile round-trips each month. Since Jeff is too young to drive, one of his parents will lose a day’s work each month to take him for care. After considerable deliberation with the hospital ethics committee, the decision is made to tell Jeff and his family that he will have to transfer his care to the other hospital as this hospital can no longer continue to absorb the costs of his medicines. What is your analysis of the various ethical considerations involved in this situation? Do you agree with the hospital’s decision? Explain the rationale for your decision.

Argue both sides of the issue, explicitly basing your arguments on ethical theories and/or principles.

Can you include these points also:
-the best interests of the larger community
-physicians must act on the best interest of the patient, no matter the costs
-allocation of resources
-cost containment with institutional survival.

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