Personal Responsibility and Liver Transplant
a significant role in the control of lifestyle diseases such as alcoholic cirrhosis, obesity, and cancer. In this case, alcoholism predisposes people to alcoholic cirrhosis, which is the destruction of the liver due to excessive consumption of alcohol. Bouchery, Harwood, Simon, and Brewer (2011) state that the economic costs of alcoholism are about $225.5 billion per year in the United States, and about 11% of these are healthcare costs. This means that alcoholism makes the health care system incur about $24 billion per year, which is that alcoholism is a preventable disease. In this view, the essay assesses a case of a patient who destroyed his own liver with alcoholism and further destroyed a transplanted liver due to alcohol relapse.
Regarding eligibility of alcoholics to liver transplant, decisions are made based on abstinence and the absence of other risk factors. The use of abstinence as an eligibility criterion is based on the fact that the longer the period of abstinence, the lower the chances of alcohol relapse. Varma, Webb, and Mirza (2010) state that, in the United States, transplant programs regard the abstinence period of more than six months as appropriate in determining eligibility of alcoholics to liver transplant. Patients who can abstain from alcohol for six months or more are less likely to experience alcohol relapse, and thus eligible to get a liver transplant. The absence of risk factors such as psychiatric disorders, cardiovascular disorders, chronic pancreatitis, hepatitis, and hepatocellular carcinoma enhances prognosis of the transplant. Moreover, the presence of social support from family members and rehabilitation programs are predictors of a positive prognosis.
Given that the supply of liver transplants does not meet the demand, the patient who experienced alcohol relapse and damaged transplanted liver should not receive another transplant. The patient has proved that he is not responsible for his health as he indulged in alcohol while understanding the consequences. Healthcare providers usually provide patients with post-transplant instructions, which they must follow to enhance the prognosis of their conditions (Varma, Webb, & Mirza, 2010). The decision to provide another transplant or not has moral and ethical implications. To provide another liver transplant means that individuals are not responsible for their health, and thus the health care system should carry the medical burden of irresponsible alcoholics. On the other hand, if the patient does not receive another transplant, it means that the healthcare system to alcoholics. In this view, the case provides an ethical dilemma on whether alcoholics are eligible or not for the second liver transplant after alcohol relapse.
Since the cost of a liver transplant is very expensive, it is the major factor that reduces the eligibility of the patient to receive one. Alcoholic cirrhosis causes more deaths than non-alcoholic cirrhosis in the United States, and thus poses a significant burden to the health care system (Frazer, Stock, Kershner, Marsano, & McClain, 2011). Thus, to reduce the burden that alcoholism imposes on healthcare, people should be responsible for their health. In this case, the patient should contribute greatly to his health by through abstinence. Moreover, the patient should pay a greater share of the cost involved in transplant. Thus, abstinence and paying significant cost of liver transplants would enable patients to about their health. Consequently, letting patients develop responsible behavior of abstinence and paying medical costs of their transplants would relieve the health care system of the medical burden imposed by alcoholics.