Rationing of Healthcare Services

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?

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• Patient 1: A seventy-six-year-old nonsmoker with good pulmonary and renal function is a good candidate for a heart transplant. 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. He 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.

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