You Decide:  Ethical Decision Making 

Scenario Summary

One of the great ongoing situations that calls for ethical decision making is the reality that there is almost always a greater need for something than there is a supply to meet the need.

For our assignment and scenario, the demand is the life-and-death situation of the need for transplantable organs and the rather small and transitory supply. Hard decisions need to be made, and there is little time to think things through. These are emergency situations.

Transplantable organs become available on short notice–usually because a donor has died for reasons unrelated to the organ. They need to be removed and transplanted very quickly because they only remain fresh for a limited period. Then there is the whole complicated issue of tissue type matching. There is also an ongoing concern about how long recipients can wait.

You Decide - Choices and Consequences

Scenario

Ok, Lead Surgeon, it is time to do what you do best! There is a lot at stake. The decision must be made almost immediately. Like all actions, you will need to write your decision into medical documentation before you begin. Yes, that means YOU! In the limited time before you would begin surgery, you need to consider the cases; the technical issues involved also, and write a Memorandum for the Record to document what decision you made and what considerations you included in your process. This will be on the record, so it needs to be thorough in case it needs to justify your actions at a later date.

Role

You are the Lead Surgeon in a major hospital, and by virtue of your seniority you are also the key decision maker for transplant cases. Right now you have three people who are waiting and hoping for a suitable heart to become available. Your cell phone rings suddenly, and you are notified that a heart has become available-meaning that you need to make a quick yet sound decision about which patient will receive the heart and then schedule surgery for today.