Question: Ethics in Nursing- Scenario #2 Who Will Receive the Liver? Mr. Mann is 65 years old, has been a heavy drinker since high school, and has end-stage liver disease (ESLD) due to alcoholic cirrhosis. He will soon die if he does not receive a liver. He has been unemployed for years, even before his illness, and has received state financial assistance. Mr. Mann has stated that once he receives his new liver he will try to quit drinking on a long-term basis but will make no promises. He is not drinking now because he is in the hospital and knows he must remain abstinent for a period of time before the actual organ transplant and during the recovery process. Mr. Mann is divorced, lives alone, and has two sons who are married and working.
Mr. Mann and his two sons are not on good terms. Mrs. Bay is 37 years old and has ESLD due to hepatitis B. Mrs. Bay is a wife and a mother of two children, one who is 16 years old and the other 12. The family is well known and active in the community. The family members have a great relationship. The children have stated that they do not want to lose their mother. Mrs. Bay is very sick, but she is not in the hospital. At this time, Mrs. Bay experiences days when she feels very sick and cannot move from the bed. Other days are a little better. Her prognosis is grave, and she was placed on the organ wait list ahead of Mr. Mann.
Based on your knowledge of the two diseases, you know that alcoholic cirrhosis patients with new livers may have a better success rate and longer life than do those suffering from hepatitis B, despite the fact that recovering alcoholics may have a high recidivism (relapsing to their old behavior) rate. Giving hepatitis B patients new livers is controversial, and the success rate is varied. Mr. Mann is at the maximum end of the age range for organ recipients (usually age 50 or more). Taken from: Butts, J. B. (2005). Adult health nursing ethics. In J. B. Butts & K. L. Rich (Eds.), Nursing ethics: Across the curriculum and into practice. (p. 66). Sudbury, MA: Jones and Bartlett.
Questions for discussion: What ethical principles are important in this case? How would you use ethical theories to assist you to make a decision? What should be done in this situation? What helped you to decide?