ETHC 445 Week 4 Greater Good Analysis

Student Name

Chamberlain University

ETHC-445 Principles of Ethics

Prof. Name

Date

Introduction

This paper explores the ethical dilemmas involved in deciding which of three patients should receive a kidney transplant. Each patient presents unique characteristics, including variations in age, background, and religious perspectives. The candidates range in age from 11 to 55 years old, creating a wide spectrum of life stages and responsibilities. These differences complicate the allocation process because the decision must weigh medical urgency, quality of life, cultural considerations, and fairness. Determining the most appropriate recipient involves not only medical evaluation but also ethical reasoning grounded in philosophical frameworks.

Who Should Get the Kidney?

After careful consideration, Patient Two appears to be the most appropriate recipient for the available kidney transplant. This patient is a 55-year-old divorced woman with two children. Her medical condition is critical, and without the transplant, she is unlikely to survive beyond one month. Given the urgency of her case and the potential benefits of the transplant, she emerges as the strongest candidate among the three.

Reasons for Choosing

The decision to prioritize Patient Two is supported by both ethical and practical reasons:

Patient	Age	Circumstances	Survival Window Without Transplant	Key Considerations
Patient One	11 years	Comes from a wealthy background; has $1 million available for treatment	Longer-term options available	Can afford treatment alternatives
Patient Two	55 years	Divorced with two children; critical medical condition	Likely to die within 1 month	Highest urgency; immediate need
Patient Three	35 years	Has previously received two transplants; parents object based on religious grounds	Approximately 2 months	Prior access to transplants; family’s cultural and religious objections

The rationale for selecting Patient Two includes:

Urgency of survival: Her health condition is most critical, requiring immediate intervention.
Family responsibility: As a parent, her survival directly impacts the well-being of her children.
Limited alternatives: Unlike Patient One, she does not possess the financial means to pursue treatment independently.
Fairness in access: Patient Three has already benefited from two prior transplants, raising concerns about equitable distribution of scarce resources.

Ethics of Egoism

Ethical egoism emphasizes actions that primarily serve self-interest. In this case, Patient Three represents egoism because she has already received two prior transplants, prioritizing her survival above broader considerations such as fairness or the beliefs of her family. Her actions seemingly disregard her parents’ religious and cultural objections to organ transplantation. According to Rachels (2018), egoism can sometimes result in decisions that privilege one’s welfare while neglecting communal or ethical duties. This perspective highlights the tension between individual benefit and societal fairness in healthcare allocation.

Utilitarianism in the Scenario

From a utilitarian standpoint, the morally correct choice is the one that maximizes overall happiness or minimizes suffering for the greatest number of people. Patient Two’s survival not only extends her life but also benefits her dependent children, thereby producing broader positive outcomes. However, utilitarianism faces limitations in this scenario. Only one kidney is available, and choosing a single recipient inevitably excludes others. This scarcity challenges the utilitarian principle of equal happiness, forcing decision-makers to balance individual and collective welfare in a way that cannot satisfy all parties simultaneously (Jonsen, 2012).

Hobbes’ Argument

Thomas Hobbes argued that human beings, in pursuit of their desires, may resort to conflict or force if resources are limited (Messerly, 2015). While the transplant scenario does not involve physical violence, it demonstrates how power dynamics and competing interests shape decision-making. The allocation process could easily favor the individual with greater influence, wealth, or access. However, ethical frameworks and institutional guidelines exist to prevent such dominance, ensuring that even the weaker or less influential candidates are given fair consideration. This aligns with Hobbes’ idea that societal rules are necessary to prevent chaos and enforce justice.

Conclusion

The ethical challenges of kidney transplantation decisions are profound, shaped by urgency, fairness, cultural beliefs, and moral philosophy. In this scenario, Patient Two is identified as the most deserving recipient due to her immediate medical need, her responsibilities as a parent, and her lack of alternative options. While frameworks such as egoism, utilitarianism, and Hobbesian thought provide different lenses for analysis, the ultimate decision must balance individual survival with societal fairness. Ethical and legal guidelines are critical in guiding these difficult choices to minimize bias and ensure equitable distribution of life-saving resources.

References

Jonsen, A. R. (2012). The ethics of organ transplantation: A brief history. AMA Journal of Ethics, 14(3), 264–268. https://doi.org/10.1001/virtualmentor.2012.14.3.mhst1-1203

Messerly, J. (2015, May 1). Summary of Hobbes’ political and ethical theories. Reason and Meaning. https://reasonandmeaning.com/2015/05/01/hobbes-political-and-ethical-theories-in-two-pages/

Rachels, J. (2018). The elements of moral philosophy (9th ed.). McGraw-Hill Education.