Scarce goods : justice, fairness, and organ transplantation / Tom Koch.

Format:

Book

Author/Creator:

Koch, Tom, 1949-

Language:

English

Subjects (All):

Transplantation of organs, tissues, etc--Moral and ethical aspects--United States.

Transplantation of organs, tissues, etc.

Transplantation of organs, tissues, etc--Social aspects--United States.

Transplantation of organs, tissues, etc--Law and legislation--United States.

Social justice--United States.

Social justice.

Physical Description:

1 online resource (xvii, 250 pages) : illustrations

Edition:

1st ed.

Place of Publication:

Westport, Conn. : Praeger, 2002.

Language Note:

English

Summary:

In 1841 the American sailing ship William Brown struck an iceberg. About half of the passengers and all of the crew were saved in two small, open boats. The next night, half of the passengers in the larger long-boat were thrown overboard because the boat was overfull. This was the first case of lifeboat ethics, of hard choices in the face of scarcity. Since then the question has been who should die so that others, equally needy, might live? Both the case of the William Brown and the ethics it spawned have been used in recent years to describe the problem of health care rationing generally, and organ transplantation specifically. Koch reexamines and reinterpretes the paradigm case of lifeboat ethics, the story of the William Brown, not as an unavoidable tragedy, but as an avoidable series of errors. Its relation to more general issues of distributive justice are then considered. The lessons learned from both the historical review and its application to distributive principles are then applied to the problem of graft organ distribution in the United States. Through the use of maps, the problem of organ distribution is considered at a range of scales, from the international to the urban. The contextual issues become more evident as one moves from international to hemispheric, fron national to regional, and then local systems. Finally, Koch reviews the lessons in light of other problems of distribution in the face of scarcity. The central lesson-that scarcity is exacerbated where it is not in fact created by our distributive programs-is explored thoroughly. The result is no good choices for anyone and the continuation of the scarcity that for most seems inevitable, but, from the evidence provided, is itself an outcome of inequalities of distribution at different scales of society. Of particular interest to students, scholars, and policymakers involved with issues of planning and health care economics, medical geography, and concepts of justice.

Contents:

Machine generated contents note: 1 Lifeboat Ethics and the Case of the William Brown

Health Care

The William Brown

The Gulf Stream

A Constructed Tale

The Trial

Lifeboat Ethics Redux

The Titantic

2 The Scales of Justice: Principles and Practice

Distributive Justice

Scarcity

Justice Rationales

Critiques

Transplantation

A Geographical Approach

3 Scarce Goods: The Contexts of Solid Organ Transplantation

Transplantation: The Early Years

Cyclosporine: Transforming Scarcity

A National System

National Organ Transplant Act

Regionalization

An Example

Discussion

4 The Scale of Justice: Theories and Realities

Perspective and Scale

Global/Interational Scales

Hemispheric Perspective

Justice and Scale

5 Disappearing States: The Scale of the Nation

Regional Inequalities

Centers of Excellence

Distant Cities

Redistricting

Travel Time (Distance)

6 The Scale of the City: Distant Communities and the

Problem of Supply

Rural versus Urban Care

OPO Performance

Demographics and Membership

Poverty and Race

A Sense of the Game

Application: Southern California

7 The Lifeboat's Choice

Lifeboat Seats

Results

Q-Analysis

8 Justice in Ethic's Lifeboat

Dimensionality

Participation

Philosophical Concerns

Reasons and Persons

The Scarcities We Create

Afterword

Holmes' Legacy

Abundance and Scarcity.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references (p. [199]-239) and index.

ISBN:

9786612573750

9780313390807

0313390800

9781282573758

1282573756

9780313074868

0313074860

OCLC:

928191057