¶ … Tummy-Ache Debate
A woman complains of abdominal pain and is rushed to the hospital. After an examination, the physician informs the woman that she needs a kidney transplant. However, based on the managed care organization's utilization management review, a nurse practitioner decides to deny the procedure for this patient. The woman eventually dies as a result of not having the transplant.
I personally feel that managed care organizations should provide the best possible care that they can and should have provided treatment to the woman after the physician after her diagnosis. However, on the other hand, it should be noted that there are also many factors that could be entirely relevant that are not specifically outlined in the scenario. For example, there are not typically enough livers that are available to treat every patient that is in need of one at the time. Therefore, there has to be some way to determine which patients receive these vital resources and which do not, and these can be difficult ethical conundrums for anyone involved. Unfortunately for many managed care patients, there is often a financial aspect to such decisions that often leave them in a weakened position to negotiate for the approval of the treatments. For example, while there is typically...
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