Final Draft Health 107 Position Paper Part B
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Brock University *
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107
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Health Science
Date
Feb 20, 2024
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12
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Health 107 Position Paper Part B
Jack Lacelle
21061823
TA: Evi Zafiris
Health 107
November 10, 2023
Due: November 24, 2023
1
Link to ChatGPT essay
The title of my AI produced essay: Considering Lifestyle Choices in Organ Transplant
Allocation: A Proponents Perspective
Link: https://chat.openai.com/share/66bf8d9c-1344-4ba4-a606-b49916bbb219
Rough Notes for Critically Evaluating ChatGPT Essay
・
To begin, however not directly related to the information, in the intro “The allocation of
organs for transplantation is a complex and ethically challenging process that involves balancing
the principles of justice, fairness, and medical necessity. One controversial aspect…” (OpenAI,
2023). I believe when I actually write my essay, my intro should be much for personalized, and I
should make a thesis statement for my perspective rather than being as ‘on the fence’ as the AI
intro.
・
I felt the AI worded the sentence “The allocation of organs for transplantation is a
complex and ethically challenging process that involves balancing the principles of justice,
fairness, and medical necessity” (OpenAI, 2023), well. I think the overall comparison of ethics
vs. necessity is a main point in the position paper therefore I think it was good to re-state.
・
Important arguments for the pro perspective. Included four: public perception and trust,
and three major ones I found while research in personal responsibility, adherence to medical
recommendations, and lastly resource allocation.
・
I believe the points provided with resource allocation were relatively strong. For
example mention of supply and demand, and demand being much higher than organs supplied
for medical transplants.
2
・
I found the point of adherence to medical recommendations very interesting and very
supportive towards the pro perspective of my position paper. It encourages denying certain
patients based off lifestyles such as smoking or drinking. These habits can lead to needing organ
transplants, and adherence to medical recommendations in my opinion proves to be a factor in
denying or accepting. OpenAI (2023) states that from a pro perspective, smoking and drinking
habits are brought to mind as failure to adhere to health recommendations such as not drinking
can be a factor to deny transplant, as people with these habits are more likely to impact the effect
of the transplants (OpenAI, 2023). – potentially wasting a treatment with little supply compared
to demand as mentioned above.
・
Good conclusion in regards that it restates each argument, and the important of an
ethical issue such as organ transplants and the effects on lifestyle.
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3
Fairness in Organ Transplantation: Weighing Lifestyle Choices
Organ transplants remain as one of the most remarkable achievements in modern
medicine, offering a lifeline to individuals whose lives are threatened by failing organs caused by
various health factors. However, the ever-growing demand for organs far outpaces the available
supply, posing ethical dilemmas in determining who should be prioritized for these life-saving
procedures. Despite often being considered unethical, I believe the consideration of lifestyle
choices as a factor in organ recipient selection is a necessary step towards equitable distribution
of a scarce and invaluable resource. By integrating lifestyle assessments into the transplant
evaluation process, I think it can promote a more fair system that takes into account both medical
need and responsible health practices, ultimately fostering a more responsible and balanced
approach to organ allocation. Despite many who believe organ transplant should solely be based
on health condition, I believe people who need transplants due to uncontrollable diseases or
health issues should recieve organs first over individuals who may have encouraged or
unknowingly caused their health conditions by long periods of smoking, drinking, or other
negative habits.
To begin, one of the primary arguments in favor of denying organ transplants based on
lifestyle choices is the optimization of the allocation of scarce resources. The challenge of organ
shortages in transplantation is very evident. The gap between demand of organs and supply
continues to grow, with a current waiting list of just over 103,000 in the United States alone
(HRSA, 2023). With the supply of organs significantly lower than the demand, many such as
myself argue that introducing criteria such as evaluating lifestyle could prove to be a good thing.
4
Consider the hypothetical scenario where two individuals are on the organ transplant waiting list,
both with comparable and similar medical needs. In this context, I contend that allocating organs
to individuals who demonstrate a commitment to responsible health practices could prove to
show more favorable outcomes. A body that has withstood years of smoking, drinking, or in
other words constant abuse are less likely to function properly even after a transplant. Research
has shown a correlation between certain lifestyle habits, such as smoking and obesity, and
post-transplant complications (Ellulu et al., 2017). By factoring in lifestyle choices during the
evaluation process, transplant organs may be directed toward recipients who are more likely to
care about their well-being, and adhere to post-transplant care regimens, thereby maximizing the
effectiveness and longevity of the transplant (OPTN, 2023). In essence, this approach aligns with
the overarching goal of achieving the greatest possible benefit from the limited pool of available
organs and ensuring a responsible and judicious use of this invaluable resource. Despite seeming
unethical to deny certain people medical treatment, seeing lifestyle as a factor can ensure those
who do need organs and do make smart choices are not left waiting for organs, and it ensures
people who are ‘un-fitting-, and may ‘waste’ a transplant by not taking care of themselves are
put at a lower priority.
Furthermore, considering lifestyle choices in the healthcare system can enhance
trust and confidence in its operations. Sustaining public trust in organ transplantation is pivotal
for its ongoing success. Integrating lifestyle considerations into the transplant system illustrates a
commitment to responsible resource allocation and ethical decision-making (Bunnik, 2023). To
illustrate, it seems inequitable for a transplant candidate struggling due to past substance abuse to
receive the same priority as someone facing a similar need arising from an uncontrollable illness.
5
Denying someone based on lifestyle choices, I argue, is more ethically sound than treating both
cases identically. This additional transparency that comes with noticing and acknowledging these
factors may help foster public confidence in the fairness and integrity of the organ transplant
process, reducing skepticism and people losing hope in receiving help and promoting a sense of
equity among potential organ donors and the general public (Etheredge, 2021).
Lastly, along with prioritizing scarce allocation of resources, and creating a better sense
of ‘trust’ in healthcare, I believe the notion of prioritizing individuals with healthier lifestyles for
organ transplants is overall framed as a strategy to foster fairness and equity as a whole, and
caters to support those who take care of themselves and are struck with disease (Hackmaan,
2022). Proponents of this perspective like myself argue that individuals who actively engage in
healthier habits should be granted a higher likelihood of receiving life-saving organ transplants
(OpenAI, 2023). This approach aligns with the principle of rewarding responsible choices. By
considering lifestyle choices, the system aims to create a more equitable framework that
acknowledges and rewards individuals who have demonstrated a commitment to maintaining
their health (Tulchinsky, 2018). While this perspective introduces complexities and ethical
considerations when it comes to the immediate argument of ‘saving a life’, however when looked
at in a more complex way, it may leave some people who require organs left to wait, which in my
opinion is a larger ethical issue. The underlying premise revolves around the idea that fairness
can be achieved by recognizing and incentivizing responsible health practices in the context of
organ transplantation, and I think overall as mentioned in point two, it can lead to a better health
care system overall (Dalal, 2015).
Oppositely, there is a large counter argument for why lifestyle shouldn’t be a factor in
determining recipients for organ transplant. Some points which do raise a fair case are as
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6
follows: To start, medical need and urgency. Critics argue that the primary consideration for
organ transplantation should be the medical need and urgency rather than lifestyle choices.
Denying organs based on lifestyle may disproportionately affect individuals with conditions
beyond their control, creating an unfair system (Bunnik, 2023b). Denying based off of lifestyle
could also leave someone at risk for death if they absolutely needed one, but these lifestyle
choices were bad. Even though they made those choices, death or being left without any
treatment should not be the option, and is not ethical. Another point raised is stigmatization and
discrimination: Denying organ transplants based on lifestyle choices could lead to stigmatization
and discrimination. This approach may disproportionately impact marginalized communities and
reinforce existing health disparities, as certain groups may be more likely to engage in risky
behaviors due to socioeconomic factors (Togioka, 2023). Next, defining and assessing "lifestyle
choices" can be highly subjective. Determining who qualifies or does not qualify based on
behaviors like smoking or drinking raises concerns about the potential for bias, lack of
objectivity, and inconsistency in decision-making (OpenAI, 2023). Additionally, many people
smoke and drink for factors outside of their control, or even are pressured to, showing it is not
always reflective of someones identity. Lastly, potential for behavior change. Opponents argue
that denying organ transplants based on lifestyle choices may overlook the potential for behavior
change (Kates et al., 2021). Individuals facing life-threatening conditions may be motivated to
adopt healthier habits after a transplant, making them more likely to lead healthier lives in the
future.
In conclusion, the debate surrounding the consideration of lifestyle choices in organ
transplantation is complex and multifaceted. While there are compelling arguments in favor of
integrating lifestyle assessments into the transplant evaluation process, it is essential to
7
acknowledge and address the counterarguments that emphasize the importance of medical need,
urgency, and potential for behavior change. The optimization of scarce resources, fostering trust
in healthcare, and promoting fairness and equity are key objectives underlying the proponents'
stance. The transparency in considering lifestyle factors aims to ensure a responsible and
judicious use of organ resources, catering to individuals who actively prioritize their health.
However, critics emphasize the risk of stigmatization, discrimination, and potential biases,
arguing that medical need should be the primary determinant in organ allocation. Balancing these
perspectives is crucial for developing a nuanced and ethical approach that takes into account both
the complexities of healthcare decisions and the need for fair and equitable distribution of
life-saving organs. As advancements in medical science and ethical considerations evolve, the
ongoing discourse on lifestyle choices in organ transplantation will continue to shape the ethical
landscape of healthcare practices.
Questions
・
What was useful about using the ChatGPT essay at the start of this process?
I found it useful as it gave me ideas to begin picking a side for my position on the topic, it really
got the ideas flowing. As for using it during the essay aspect, I found it helpful as it layed the
bases as kind of what I should include in mine, and generally just layed a foundation for the start.
・
What key limitations about ChatGPT have you learned through this process?
8
I have learned some limitations. For example, ChatGPT does not always give good information,
or true information, so I must be careful how I use it. Also, sometimes the information it gives is
not very credible, or scholarly like our information should be in this assignment.
・
Has this assignment impacted your beliefs about using generative AI tools (like ChatGPT)
in your everyday life? Why or why not?
I believe it has. Before this semester I had never had used it, therefore everything I’ve learned
this semester about it is what I know, it has shaped my beliefs.
・
What was the most challenging part of this assignment?
In my experience, the most challenging part was finding good information for both sides.
Currently in health, it usually not ethical to deny anyone an organ transplant based off lifestyle
choices, and saving lives is prioritized therefore most points from one side are hypothetical, but I
thought I’d challenge myself and choose that.
・
What are you most proud of from this assignment?
I am most proud of learning about organ transplants. Also researching both sides and looking at
it from an open mindset, and seeing various peoples different opinions on such a ethically
concerning topic such as organ trasnplants, and lifestyle choices.
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9
References
Bunnik, E. M. (2023b). Ethics of allocation of donor organs.
Current Opinion in Organ
Transplantation
,
28
(3), 192–196.
https://doi.org/10.1097/mot.0000000000001058
Caplan, A. (2014). Bioethics of Organ Transplantation
Cold Spring Harb Perspect Med.
SSSSSS
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935394/
Dalal, A. (2015). Philosophy of organ donation: Review of ethical facets.
World J Transplant.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478599/
Ellulu, M. S., Patimah, I., Khaza’ai, H., Rahmat, A., & Abed, Y. (2017). Obesity and
inflammation: the linking mechanism and the complications.
Archives of Medical
Science
,
4
, 851–863. https://doi.org/10.5114/aoms.2016.58928
Etheredge, H. (2021). Assessing Global Organ Donation Policies: Opt-In vs Opt-Out.
Risk
Management and Healthcare Policy
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Volume 14
, 1985–1998.
https://doi.org/10.2147/rmhp.s270234
10
Ethics - General Considerations in Assessment for Transplant Candidacy - OPTN
. (n.d.).
https://optn.transplant.hrsa.gov/professionals/by-topic/ethical-considerations/general-con
siderations-in-assessment-for-transplant-candidacy/
Hackmaan, M. (2022). Confronting and Eliminating Inequities in the Organ Transplantation
System. https://www.ncbi.nlm.nih.gov/books/NBK580030/
Kates, O. S., Stohs, E., Pergam, S. A., Rakita, R. M., Michaels, M. G., Wolfe, C. R.,
Danziger
‐
Isakov, L., Ison, M. G., Blumberg, E. A., Razonable, R. R., Gordon, E. J., &
Diekema, D. S. (2021). The limits of refusal: An ethical review of solid organ
transplantation and vaccine hesitancy.
American Journal of Transplantation
,
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(8),
2637–2645. https://doi.org/10.1111/ajt.16472
OpenAI. (2023). https://chat.openai.com/share/66bf8d9c-1344-4ba4-a606-b49916bbb219
OPTN. (2021). General Considerations in Assessment for Transplant Candidacy.
Ethical
considerations.
https://optn.transplant.hrsa.gov/professionals/by-topic/ethical-considerations/general-con
siderations-in-assessment-for-transplant-candidacy/
Organ donation Statistics | Organdonor.gov
. (2023, October 1).
https://www.organdonor.gov/learn/organ-donation-statistics
11
Togioka, B. M. (2023, August 14).
Diversity and discrimination in healthcare
. StatPearls - NCBI
Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK568721/
Tulchinksky, T. (2018). Marc Lalonde, the Health Field Concept and Health Promotion.
Case
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Studies in Public Health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150308/
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