Healthcare services can be rationed by governmental rationing or by allowing those who can afford the services to purchase the services. If you were the chairperson of a medical ethics committee faced with the decision concerning which of the following patients would receive a heart transplant, what decision would you make and what justification would you give to the families of each of the patients for making that decision?
Patient 1: A seventy-six-year-old nonsmoker with good pulmonary and renal function is a good candidate for a heart transplant, and his life expectancy without the transplant is one month. The patient has the resources to pay cash for the transplant procedure and follow-up care.
Patient 2: A forty-six-year-old unemployed auto worker with a history of alcohol use and smoking suffered a heart attack and will die within one month if he does not receive a heart transplant. The patient does not have health insurance, nor does he have the resources to pay for the procedure.