Organ Allocation and Nursing Ethics
Most of the activities the essence of which lies in the interaction with people are associated with a lot of moral issues and challenges. Nevertheless, nurse is one of the posts which is most often exposed to moral dilemmas. One of the choices that should be made by each nurse concerns the decision of an organ allocation problem between people in need. There are several different opinions on this topic and various methods of its solution, but in my mind, the golden rule model is the most consistent with my moral principles.
To begin with, the organ allocation problem is one of the most spread issues that are faced by each nurse during the practice. Every health care professional knows that “the organ is a precious resource which, if not efficiently used, is lost to another potential recipient” (Jonsen, 2012). Thereby, the discussed challenge is based on many factors such as lack of internal organs, insufficient number of donors, and many patients who need organ transplantation. It should be noted that all of these points lead to the fact that each health worker has to solve a moral problem of how to distribute the available internal organs and ensure that the decision made is ethical. Wherein, there are several opinions about how the system of organ allocation should work among patients.
First of all, some people believe that the whole country should have a single system of distribution of this type of medical resources. Thereby, the state may use a unified national organ allocation system which should take into account the opinion of the majority in order to make the system useful and morally correct. Nonetheless, this method has several weaknesses. Each state may have different views on the same moral problem because people have diverse beliefs and historical heritage in every part of the country. Thereby, it is almost impossible to use the opinion of the majority provided that dozens of individuals will suffer greatly from the immoral law from their point of view. Moreover, it may take decades to create this king of system properly, but people need organ transplants every day, and it is a moral issue that is faced by many doctors just now. Additionally, many interested persons think that each state or each individual hospital should answer this question by itself. This may be useful due to the fact that each of the mentioned entities may address the needs of its specific population and support the organ allocation system at the proper level. Nevertheless, there is a disadvantage in this method. Many physicians will experience difficulty in changing jobs if using this system. They may not understand the moral values of the other state hospitals. Accordingly, there are several different opinions on this subject. Nonetheless, every doctor should make this choice on his/her own using certain models of behavior.
The next issue refers to the fact that every doctor has a wide range of models of behavior in order to solve the moral problem of allocation system. Most often, medical professionals choose between three options. The first model is Egoism-Act, according to which the doctor makes every effort to cure patients capable of paying, and then he/she drives his/her attention to others in need. Nevertheless, “the nurse’s first obligation is the well-being of the patient entrusted to our care” (MNA Center for Ethics and Human Rights, 2011). Thus, health workers are obliged to help each patient rather than choose a specific person. Most people who may be cured if another form of behavior is used, will remain without treatment if this method chosen. Secondly, some individuals believe that “it is essential to ensure that new and innovative laws, policies and strategies of increasing organ supply are bioethical and are founded on the principles of altruism and utilitarianism” (Dalal, 2015). Thereby, many people hold the idea of utilitarianism which states that it is necessary to balance the good and bad deeds. Nevertheless, it should be borne in mind that it is impossible to provide organs to all patients who need them. “According to the Brazilian Transplantation Register, about 30,547 people are awaiting organ transplantation in 2012” (Mendes, Roza, Barbosa, Schirmer, & Galvão, 2012), that proves that too many individuals are in need of transplantation every day. The third possible method of behavior is the Golden rule. The essence of this approach is that, to make a choice, the nurse reflects on the problem from the perspective she would like her doctor to apply to make a decision if she was a person in need. Thus, each patient who necessitates a transplant immediately gets help. This way, no person in need will be forgotten or neglected by the doctor. In my mind, it is absolutely right to support this method, since it coincides with many of the values that I share.
As for the values that are guiding me in choosing the Golden rule as the correct behavior model, I maintain the core values for nursing by the National League. First of all, I believe that one of the most important moral nurse’s tasks is caring about patients. According to this point of view, each medical worker has to be able to help the patient as much as it is possible. Thereby, this moral principle is absolutely consistent with the Golden rule in the process of allocation of organs for transplantation. In the second place, another vital point in the moral education of each nurse is integrity. This principle means that these health care professionals should not be biased. Each of them has to help every person regardless of gender, age, race, and social status. Moreover, the nurse should not pay attention to the disease of his/her patients to select only easy and ordinary problems in order not to be bothered. Thus, the Golden rule is also satisfied. If the health care worker treats his/her patients as well as himself/herself, he/she will cure them with greater probability. In the third place, the diversity is also an important part of one’s moral if working as a nurse. Since many people follow many different national and religious rules in their everyday life, the nurse has to be able to understand these peculiarities and adjust to them. For example, he/she should not try to persuade a person to become an organ donor if the latter is strongly convinced that this practice is improper due to his/her religion. This also coincides with the method of the Golden Rule. In the fourth place, excellence is one of the essential skills for every nurse as each of them should be able to ensure the rapid adoption of solutions for patient care. That is why, in my mind, the correct approach to use when solving ethical issues in the field of organ transplantation is the model of the Golden rule.
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In conclusion, it should be noted that the distribution of organs for transplantation is the process associated with many ethical problems. There are different opinions regarding whether the countries should have single or diversified systems in this area. Nevertheless, currently, nurses solve these dilemmas independently and on their own. In this case, the Golden rule is the best pattern of behavior as it corresponds to my moral and ethical principles to the fullest.