The Ethical Dilemma of Denying Organ Transplant to People with Cognitive Impairments

Junior (College 3rd year) ・Healthcare&Medicine ・APA ・1 Sources

The article, Allocating Organs to Cognitively Impaired Patients by Halpern & Goldberg (2017),  discusses the discrimination that exists in organ transplants in light of people with disabilities. This discrimination becomes an ethical dilemma given that the providers of healthcare make decisions regarding not only the value of life but also the quality of life for those who are allocated or denied the organ transplants. As such, where denial of organ transplantation occurs due to impairments in the cognitive functions of patients, such lives are seen as less valuable and hence denied a high-quality life. This paper will discuss the ethical and legal issues highlighted by the article and how these issues have been solved. 
To begin with,  three ethical and legal issues namely equity and efficiency, quality as well as survival after denial of transplant, and the mechanism for accountability and reasonableness are highlighted by the article. While the issue of equity and efficiency aligns to justifications pertaining to equal opportunities among different demographics and increasing the quality of life for all, quality and survival issues after transplant relates to the survival rates as a result of adherence to postoperative requirements. The last issue, mechanism for accountability and reasonableness, highlights the lack of systems that hold transplant centers accountable for each specific decision for or against a patients access to organ transplant.

Given the above dilemma, the article shows that the issue has not been solved. This is based on the recent petition by members of Congress calling for guidance from the Department of Health and Human Services as regards this issue. As such, the discrimination against people with disabilities is still an issue that both the health industry and government have to solve.

The paper has discussed the ethical dilemma associated with denial of organ transplantation to people with disabilities. Given the importance of equity and efficiency as well as the quality of life and postoperative survival rates, it is my view that the healthcare system has not achieved its core purpose towards providing quality health for all people. By acknowledging that certain instances may necessitate the denial of the organ transplant especially as regards those in a vegetative state, other instances do exist where the quality of life and survival rate would be increased for individuals with cognitive impairments. As a means of achieving equity and efficiency, I do agree with the authors towards the creation of accountability systems that will be used in transplant centers as a way of ensuring that there is a decline in the discrimination that is present in our healthcare system.


Halpern, S. D., Goldberg, D. (2017). Allocating Organs to Cognitively Impaired Patients. The New England Journal of Medicine, 376, 299-301. doi:10.1056/NEJMp1613858

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