Case 8.2 discusses the issue of vertical aid programs, programs that are intend to target a specific disease. Dr. Arman Asadour has been sent to a town in South Sudan to set up temporary work stations for the treatment of cholera. Dr. Asadour is under the strict jurisdiction of the non-governmental organization (NGO) to treat ONLY those patients who present symptoms of cholera and to direct all other cases to the local hospital. While the NGO possesses the medical supplies necessary to treat other cases, they fear that an integrated program will reduce the number of cholera patients who are able to benefit from the work station. How should Dr. Asadour decide which patients to treat (Thomas et al., 267-268)?

This case study reminded me of Friday’s class debate. In class, we were asked if individuals who have suffered from extreme alcohol abuse should have the same right to a liver transplant as non-alcoholics (note the phrasing is slightly different)? While I don’t think that a consensus was ever reached, I want to highlight several of the arguments made by each side. The pro side stated that liver transplants should be based on the potential success of the treatment and that alcoholics are likely to abuse the new liver as well. By contrast, the con side argued that alcoholism is highly affected by social and biological determinants such as genetics, location, peer pressure etc. with genetics accounting for 50% of the risk for alcohol use disorder (“Genetics of Alcohol Use Disorder”). Though the debate was not ultimately decided, Beachamp and Childress argue that although individuals with alcoholic use disorders who receive a liver transplant and continue to abstain from alcohol tend to do as well as other patients there is reason to exclude high risk patients altogether (Beauchamp et al.,275). For example, they argue that the alcoholic who fails to seek effective treatment for alcoholism prior to receiving a liver transplant should receive a lower priority for treatment (Beauchamp et al.,276).  Like the case debated in class, case 8.2 is also based on the allocation of limited resources.

Unlike the case presented above, case 8.2 discusses the decision to provide basic healthcare to patients unaffected by cholera. That being said, I believe that cases such as case 8.2 and the case debated in class should be decided on a case by case basis. While I understand that such a platform does not yield to both national and global health policy, I believe that all people have a right to a decent minimum of health care. According to one theory presented by Beauchamp and Childress, healthcare should be thought of as a two-tiered system with the first tier meeting needs by “providing universal access to basic services” while the secondary tier covers “better services” that can be acquired with voluntary private coverage (Beauchamp et al., 273). Under this mandate, patients seeking basic needs would be able to seek treatment at work stations.

Beauchamp, Tom L., and James F. Childress. Principals of Biomedical Ethics. New York: Oxford U.P., 1983. Print.

“Genetics of Alcohol Use Disorder.” National Institutes of Health. U.S. Department of Health and Human Services, n.d. Web. 15 Apr. 2017.

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. Peterborough, Ontario: Broadview, 2014. Print.