Names:_____________________________________________________________Date: _______

The Desperate Dozen: A Problem of Biomedical Resource Allocation

medical icon

The list below shows a dozen candidates waiting for a heart transplantation.  Assume that on the average there is one transplantable heart per month for candidate pool.

Your Task: Rank the candidates in order for the next heart, which has just become available. Describe the ethical foundation upon which your priority selections are made and explain its application to each ranking you make. 

Person & Age

Critical Need

Relative Immunology
“Match

Resulting Quality of Health

Estimated # of yrs to Death

Ability to Pay

Comment & Rank

Surgeon, 62

95

80

45

4

99

 

Mechanic, 25

60

60

85

5

25

 

Mother of six, 36

50

90

70

13

90

 

Politician, 44

75

50

60

10

80

 

Famous  Singer, 30

80

80

70

25

92

 

Writer, 56

60

95

60

15

40

 

Criminal, 31

70

90

97

35

60

 

Your Mother, 55

90

90

30

8

50

 

Astronaut, 32

75

70

60

20

60

 

Autistic Child, 14

60

80

75

18

75

 

Scientist, 34

80

60

70

12

50

 

You, -

70

80

50

4

45

 

Evaluation
scales

100=Immediate
90 = 1 week
80 = 2 wks.
70=1 month
60=2 mths.
50= 4 mths

100 =
Perfect
90 =
Excellent
80 = Very good
70=
Satisfactory
60=Marginal
50=Risky

90 = Marathon runner
80=Active
70=Normal
60=Ambulatory
only
50=Disabled,
weak
<40=Bedridden

 

 

Number is
% of costs patient can pay by self or    insurance

 

Further discussion:  would your rankings change if:  

A)  Mother of 6 was homeless, on Medicaid
B)  Auto mechanic was a registered sex offender
C)  Your mother has early Alzheimer’s symptoms
D)  Politician has views that were different from your own
E)  Research scientist specializes in immunology
F)  Singer has donated thousands of dollars to charitie
s

**Adjust your ranks according to this new information, use a different color to indicate changes made from your first list.

 Final  Task

Based on your tanks and discussion with your team, develop a unified ethical basis for making biomedical decisions about transplants with consideration to limited resources.   Your plan should address how transplant committees should decide who gets hearts first and why some might be placed at the end of the line.    You can write this as a paragraph or a bulleted list that shows how these decisions will be made.