Every countries has its own health care system. Is one better than the other that we should adopt the best one in the world? Should we have the same health care system in each country so that everyone can be equal? People may have wondered why don’t we just copy exact the same thing like France, the best healthcare system according to Business Insider?

In Taiwan, where I live for almost my entire life, our health care system is National Health  Insurance, which almost everyone is covered just paying taxes and minimal fees. However one major problem that we are facing is that it’s too cheap that people especially elders go to the hospitals so often even when they don’t have problems. Basically many people abuse the health care by getting medicines so often that they don’t need it. This situation causes the government to waste a lot of money. So how can we solve this situation? To increase the payment for health insurance? In fact, the Taiwanese government has tried to implement a health care reform that bases on income, in which the government can gain a bit more money to avoid bankrupt. However, some people believe that this might influence some lower income families not being able to pay the medical bills.

During this spring break, I went to Nicaragua and found out that they also have national health insurance. Citizens don’t pay anything for public medical services. Doesn’t it sound good? But there are a lot of underlying problems. For example, the quality. The quality isn’t as great. The hospitals lack medical resources but not patients. Everyday, the hospitals are full of people lining up. People have to wait for hours and hours to actually get to see the doctors. Even the doctors and nurses aren’t well paid. Then one might think, is this problem caused by the free medical services? Not exactly, the culture, society, geography, and the economy also play major roles in health care. In addition, because of poverty, the citizens have hard to transporting to the main cities to the hospitals. Therefore besides from quality, access is also another problem that the Nicaraguan government is facing.

In the article “Access to Health Care,” it gives us three interesting cases. In case A, is it fair that once a person lose his job, he loses his health insurance and not being to get access to health care? And for case C, the professor is not eligible to get Medicaid payment for nursing home care for Alzheimer’s disease. Alzheimer’s disease is also a health problem, then why can’t it be included in Medicaid. It is indeed really hard to come up with the best health care, which everyone is under coverage. The government has to consider many factors not just the percent coverage of health care but also the affordability, quality, and accessibility. Since health is also a human right, everyone should have the right to be healthy and get access to good health services. But is it possible to come up with the perfect health care in which everyone is equal? Or when does health care system consider as socially acceptable to everyone?

Sources

B. Brody and T. Engelhard,  “Access to Health Care,” Bioethics: Readings and Cases

In these decades, informed consent has been a significant medical issue. People still aren’t sure what kinds of actions to take in some cases. For example, should doctors respect the patients or the patients autonomy? Also how much information should the doctors provide their patients? These situations are really hard to deal with because there are many barriers to informed consent such as patients’ and doctors’ attitudes, medical system, and the information given for the decision making. In the following example, it shows a recent article that deals with informed consent.

On February 2, 2014, there there was a news called “Donor’s death shatters family, stuns surgeons” (www.bostonglobe.com). Paul Hawks, who was 56 years old, decided to donate some parts of his liver to his brother-in-law Tim Wilson, who had liver cancer. However, Paul died during the liver transplant. So what exactly happened in this case? Did the doctors and the patients make the right decisions? In the article, it mentioned that Paul was considered an older donor and was also examined to have extra blood vessels and abnormalities on his electrocardiogram. However, these situations didn’t change the hospital’s transplant team’s decision on this transplant. Instead, they decided to continue this case, because they were confident since the team had never failed any transplant. Even though in this article the reader couldn’t tell if the doctors actually told Paul and his family about his age and some problems he had, it mentioned that “When the donor is a child, parent, spouse, or sibling, the recipient’s survival is more obviously paramount to them — and the donor’s acceptance of risk therefore more understandable.” It seemed to me that the doctors assumed that the patient’s choice was rational because Tim was his relative. Since the doctors were so confident of their past record, it showed that the doctors didn’t inform the information (consequences) well enough to the patients in order for the patients to make a right decision. As Robert M. Veatch had written, “But even understanding is not enough. Facts must be assembled to tell a story or to construct an argument which stands in the foreground of deliberation” (Holland pg 334). Therefore in this case, the doctors probably didn’t deliver the information in a more constructed way. The doctors should have directed the Paul to think more about the transplant and the side effects of it.

This case also raises other questions such as should the donor be able to know the recipients’s risk factors and that the recipient should know that donors have some health problems that might cause transplant failure. By disclosing these information, it allows the donors and recipients to make better judgment and decisions. However, this also leads to another situation, which is privacy. By protecting privacy, the donors and the recipients lack some information to make appropriate decision. Therefore in this case, should we care more about the privacy or the outcomes of the decision.

Kowalczyk, Liz. “Donor’s Death Shatters Family, Stuns Surgeons.” Metro. BostonGlobal, 02 Feb. 2014. Web. 02 Mar. 2014.

Most people are trying to reach perfection, but is it possible? The definition of perfection from Merriam-Webster is something that cannot be improved. But how does one know that there isn’t any improvement that can be made? Some people believe that genetic engineering can lead to perfection of humans. However Michael J. Sandel believes that designer children doesn’t drive to mastery but destroys “an appreciation of the gifted character of human powers and achievements”(Holland 97).

When parents are able to choose their children’s genes, they might want their children to be intelligent, good looking, tall, healthy, and even a specific gender. From the parents’ eyes the children might look perfect to them, but by looking at the society as a whole, designer children creates a greater potential for disparities between the rich and the poor. The rich families have the access to enhancement technologies, while the poor just maintain the natural way. If the enhancement is passed down the generations, the poor and the rich eventually become two different kinds of people. However, aren’t we trying to solve the wealth gap? If designer children actually occurs, it probably will just keep on widening the wealth gap. Ultimately, “the economic divisions may grow into genetic divisions”.

Sandel mentions that if the society approves that designer children is considered as enhancement to the society, everyone should have the access to it. This indeeds creates a problem that everyone is going to be similar. For example, if the society believes that taller people are considered more perfect than shorter people, parents are going to spend money just to make their children a little bit taller. But is it necessary to waste that money just to be like everyone else. If everyone has the access to it, the society altogether becomes more enhance and perfect than ever. However, this then raises another question, who will do all the physical labor jobs, when everyone is smart and isn’t willing to hard labor? The society eventually will collapse. Everyone just wants to be on the top of the social pyramid.

Genetics is just one part of us. The environment also plays a significant role. This means that our genes expression can be influenced by environment. For instance, the genes might be turned on or off depend on the environment, which therefore influence how humans develop. As a result, even though parents might be able to decide what they want their children to be like, it might not always have the exact same outcome they want.

The main concern I have is should we strive to perfection and what exactly defines as perfect? Everyone has a different concept on perfection; some might think that having good health is perfect, while others believe that health, appearances, and intelligence make perfection. Moreover, since everyone has different idea of a perfect child, it is going to be hard to regulate the biotechnology such as screening embryos or preimplantation genetic diagnosis. Personally, I believe that having a good health is enough. Therefore, I accept the use of biotechnologies for medical needs instead of something beyond health. It’s because nobody can become perfect

References:

Foster, Helen. “HOW TO MAKE THE PERFECT BABY.” Stylist.co.uk. Web. 1 Feb. 2014. <http://www.stylist.co.uk/life/how-to-make-the-perfect-baby>

Abarado, Anne-Marie. “Designer Babies: Creating Perfection or Breeding Trouble.” Law.uh.edu. Web. 1 Feb. 2014. <https://www.law.uh.edu/healthlaw/perspectives/2009/(AM) babies.pdf>.

Ly, Sarah, “Ethics of Designer Babies”. Embryo Project Encyclopedia (2011-03-31). ISSN: 1940-5030 Web. 1 Feb.2014. <http://embryo.asu.edu/handle/10776/2088.>

Michael J. Sandel. “The Case Against Perfection: What’s Wrong with Designer Children, Bionic athletes, and Genetic Engineering?” In Arguing about Bioethics, edited by Stephen Holland, 93-104. New York: Routledge, 2012.