As part of the Canada Health Act, all Canadians should have “access to health services without financial or other barriers,” which implies that every patient has the same right to medical treatment regardless of their gender, ethnicity, age, income, etc. (Government). The ethical issue appears when the candidates outnumber the available organs, specifically when it comes to viable body parts that draw the line between life and death. According to CBC, “one-third of Canadians needing organ transplants never receive one” (Sagan). In a situation where there are two lives at stake but only one organ to donate, physicians are obligated to decide which of the two candidates deserves to be saved sooner, if at all. According to utilitarianism, when it comes to one life versus another, the person whose survival would bring the most happiness to others should be given the organ.
Either choice results in some potential death, which is always detrimental to the Summum Bonum. Usually, the first factors that are considered are the compatibility with the organ, the urgency of the transplant and the likelihood of survival along with the amount of years the patient is getting thanks to it (Sagan). Deciding the order of the waiting list is extremely difficult because putting more emphasis on survival rates is detrimental to patients in critical condition while basing the order on the urgency would result in the loss of some who had better chances of survival. Morality is in question when alcoholics in need of a new liver are refused to be put on the list because they’re “less likely to follow through with doctor's orders, […] and alcohol can damage the new liver” (Sagan). For instance, in 2010, Mark Selkirk passed away from acute alcoholic hepatitis after being considered ineligible for a transplant (Sagan). Furthermore, the healthcare system allows the richer and more famous to get help faster since they can access multiple lists as well reach out to the public for help. Arthur Schafer, a philosophy professor, criticizes the current system by saying that “[those who aren’t media famous] are allowed to die because ... they're not as sale-able — they don't tug the heartstrings of the public in quite the same way” (Sagan).
The goal of utilitarianism being “to maximize the happiness in the world,” this ethical framework provides very case-by-case solution (Merril 21). Usually, the better approach lies in the number of lives saved since every person is worth the same, but the resulting number of people alive is the same for either option. The next best thing is to evaluate the lives of the two people based on how much happiness they bring to the greatest amount of people, which involves the age of the patient, their fame, their criminal history, etc. In the case of an alcoholic patient versus one that isn’t, the alcoholism doesn’t directly factor into the equation, but if it affected people previously and rendered the alcoholic patient friend-less, then it diminished his value to utilitarians. Another problem arises if one of the candidates is a criminal or a child. Despite them all being people with rights to medical care, followers of this school of thought would then opt for a recipient with less chances of endangering others after recovery, needless to mention the potential happiness the healthy child could bring to their family. This means that this theory would support the current health system when it favors the higher class over the less fortunate because their survival impacts more people.
If a doctor has trouble choosing whether a patient is more deserving of a vital organ than another, utilitarianism would embrace choosing a patient with a larger social impact regardless of the other factors, justifying giving it to the patient with the greatest positive impact on the greatest number of people.
Government of Canada. “Canada Health Act.” Government of Canada, 2018, https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html.
Merril, John C. “Overview: Theoretical Foundation for Media Ethics.” Controversies in Media Ethics, 3rd edition, 2011, New York.
Sagan, Aleksandra. “Organ donation ethics: How doctors decide who gets a transplant.” CBC, 2015, https://www.cbc.ca/news/health/organ-donation-ethics-how-doctors-decide-who-gets-a-transplant-1.2936439.