Drug Rehab

Question by jw: Criticise my 250 word essay on Medical Ethics.?
Hi all,

“5. A patients lifestyle choices should not alter the medical treatment.

Write a unified essay in which you address the following:

Do you agree with this ideal? Give Examples of when medical treatment may be altered as a result of lifestyle choices. What factors determine whether treatment can be given?”

My answer:
Medical treatment and treatment priority are determined by the patient’s need. The principle of non-maleficence means that life-threatening diseases are treated first.

A patient should not be penalised for their lifestyle choice through withholding treatment. Firstly, some ‘lifestyle choices’ such as being obese or addicted to smoking may be psychological diseases. Therefore, these decisions are not made in the patient’s full capacity. Since it is not the patient’s fault, it would be wrong to punish them.

In addition, it we were to discriminate against a certain group of people e.g. smokers, then we risk social engineering. The decision to treat someone would be determined by one person’s beliefs of an ideal. It would be wrong to let any subjective beliefs determine whether patients live or die.

On the other hand, lifestyle choices are sometimes the only method of discriminating against patients of equal need. For example, relapsing drinkers who cause liver cirrhosis for the second time are as needy as a drinker who has not yet had a transplant. By giving treatment to the one who has not yet had any medical intervention, we are effectively penalising the relapsed drinker. Despite this, there is a gain in social equity since everyone gets a fair chance of obtaining a first transplant.

In an ideal world, clinicians would not have to prioritise between patients due to lack of resources. Since prioritisation is necessary, discrimination must occur by some means. I feel that these decisions should be carried out by strictly regulated panels to ensure fairness.

Here is the general essay mark scheme: http://www.admissionstests.cambridgeassessment.org.uk/adt/digitalAssets/119681_BMAT_Section_3_Marking_criteria_2010.pdf

This essay is practise for my upcoming BMAT exam, I’d be grateful if you could give some guidance on how to improve both my essay technique and my ideas.

Regards,
Jon

Best answer:

Answer by Baa Baa
Just wanted to comment on your transplant info regarding drinkers. To get cirrhosis from alcohol abuse, the person would have to be an alcoholic which I believe would be a better term used instead of “drinker.”

Alcoholics needing a transplant the first time has to do added things in order to qualify that other people who need a transplant do not have to do. The alcoholic must have at least 6 months of proven sobriety before they will even be considered for a transplant. That means they must go through a rehab or some program to find out why they drink and how to remain sober for the rest of their life. They also must agree to have random drug/alcohol testing done anytime the transplant center asks them to up until they receive a transplant if they qualify for one. If they don’t agree to do these extra steps, they will not qualify for a transplant. If they are so sick that they do not have that much time (6 months) left to live, then they will die without a transplant. Getting placed on the list for getting a transplant is not easy and this is especially true for an alcoholic. There is a very extensive evaluation process that anyone wanting to be listed must pass, but the alcoholic has even more to do in order to qualify for very good reasons. This $ 300,000+ surgery would be wasted on them. A good organ would be wasted when it could have went to someone who would take excellent care of it for the rest of their life not to mention that it would save the life of someone else. Anti rejection drugs that must be taken for the rest of their life does not mix with alcohol so the liver could go into rejection if they drink again.

Now if the alcoholic managed to get a transplant after he/she does everything that is required and takes up drinking again and destroys their new liver, they will die since they never give a second liver to an alcoholic that relapsed.

I might be mistaken, but you refer to “treatment” as if that is a transplant and the two are very different. Symptoms of cirrhosis can be treated, but a transplant is the cure for cirrhosis. It’s much more than a treatment.

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