Question

Sarah is a 17-year-old undocumented immigrant who has been followed at a regional pediatric heart center since age six for single-ventricle Fontan physiology. She lives with her parents and three siblings in a rural community, where her parents struggle to avoid deportation and support their four children by working as agricultural laborers. Although Sarah and two of her siblings immigrated in childhood and are eligible for the Deferred Action for Childhood Arrivals program (DACA), Sarah’s youngest sibling was born in the United States and is an American citizen.

Sarah’s heart condition is now complicated by protein-losing enteropathy, tricuspid regurgitation, and decreased cardiac function. Her cardiologists have diagnosed her with end-stage heart disease and believe she will require a cardiac transplant to survive to adulthood. Due to her anatomy, Sarah is at a higher risk of a poor outcome if transplantation is pursued, and this risk will increase as she gets sicker. She is not a candidate for a ventricular assist device. After a discussion of the risks and benefits of a transplant, Sarah and her parents have indicated that they would like to pursue heart transplantation.

The cardiac transplantation team considers Sarah an acceptable candidate for transplantation despite her increased risk, but it has raised concerns about whether her status as an undocumented immigrant will adversely affect her ability to obtain the health care and medications required to maintain her long-term health following the transplant. In addition, there is a child who is a citizen that also needs a heart transplant on the same floor Sarah is hospitalized in. Her first surgery was performed in Mexico, but subsequent surgeries have been performed at the regional pediatric institution. The regional children’s hospital has committed to providing care and medications until Sarah reaches age 21, but the team has expressed concern about whether she would be able to afford the necessary care and medications after that point.

Which of these ethical theories applies to this scenario and explain why?

Utilitarian

Deontologic

Autonomy

Nonmaleficence

Beneficence

Justice

Fidelity

Answer 1

Utilitarianism ethics in simple refers a certain action which should be helpful or beneficence to all and not affecting others. It depends on the consequences .Here one patient is considered than other for the transplantation .The ability of the patient to afford the treatment after 21years of age is the consequence according to the theory.

Deontology ethics describes a person's duty as the priority

Autonomy refers to the patient ability to take decision by self or who has the rights to take decision for themselves

Non maleficience refers to causing no harm to patient or others

Beneficence theory refers to the work which can only provide the higher beneficial effect or no harmful effects.

Justice refers to treating every patient in equity

Fidelity refers to the trusting relationship existing or created between a healthcare professional and a patient

Ans:Utilitarian