A Liver Transplant Case Essay

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Tummy-Ache Debate

A woman complains of abdominal pain and is rushed to the hospital. After an examination, the physician informs the woman that she needs a kidney transplant. However, based on the managed care organization's utilization management review, a nurse practitioner decides to deny the procedure for this patient. The woman eventually dies as a result of not having the transplant.

I personally feel that managed care organizations should provide the best possible care that they can and should have provided treatment to the woman after the physician after her diagnosis. However, on the other hand, it should be noted that there are also many factors that could be entirely relevant that are not specifically outlined in the scenario. For example, there are not typically enough livers that are available to treat every patient that is in need of one at the time. Therefore, there has to be some way to determine which patients receive these vital resources and which do not, and these can be difficult ethical conundrums for anyone involved. Unfortunately for many managed care patients, there is often a financial aspect to such decisions that often leave them in a weakened position to negotiate for the approval of the treatments.

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For example, while there is typically some protocol or avenue to challenge decisions about the denial of various treatments, often these can be time consuming and many patients do not enough time left in their lives to complete the process.

Healthcare rationing has been extensively discussed in the medical profession and is understood as withholding beneficial interventions, mainly for cost-effectiveness reasons that occur at all levels and in all healthcare systems around the world (Papastavrou, Andreou, & Vryonides, 2014). Deciding where to ration care due to limited resources is a perplexing moral and ethical challenge in many situations, and one that is more common than most people think. For example, this type of decision is not only limited to patients who are in critical care positions. Recent studies into nursing care rationing indicate that nurses always ration their time and care, resulting to serious threats to the quality of care and patient safety; for example, patient mobilization, hygiene, feeding, communication, patient support, teaching and discharge planning, surveillance and care documentation are regularly lacking or omitted (Papastavrou, 2013).

Therefore, while my first impression of the case would be to recommend that the nurse practitioner approve the….....

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