Poor Socio-Economic Background and Conditions Term Paper

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Above all it has followed the deliberate marketing of health care (in association with tourism) as medical care has gradually moved away from the public sector to the private sector, ensuring that a growing majority of people, especially in the richest countries, and particularly in the United States, must pay -- often considerably -- for health care. Finally, growing interest in cosmetic surgery, involving such elective procedures as rhinoplasty, liposuction, breast enhancement or reduction, LASIK eye surgery and so on, or more simply the removal of tattoos, have created new demands. Various forms of dental surgery, especially cosmetic dental surgery, are not covered by insurance in countries like the UK and Australia; hence dental tourism has become particularly common. In Asia these trends are 'the unlikely child of new global realities: the fallout of terrorism, the Asian economic downturn, internet access to price information, and the globalisation of health services' (Levett, 2005, p. 27). (Medical tourism: Sea, sun, sand and y surgery)

The added problem to this of course, is that patients on dialysis are no longer able to work, and therefore cannot pay taxes. This results on a double blow on the economy. People, it is a fact, that kidney dialysis alone costs a staggering 200 million dollars per year out of the taxpayers pocket! It is believed that the total cost for caring for people on the organ waiting list equates to an enormous 5 times this amount! That is $1billion per annum! Enough to feed the whole of Ethiopia for a year (WHO 2003).

The sheer lack of organs and especially kidney organs in circulation. The poor supply of donor organs does not at present, fill the every increasing demand for them.

The illegal and unethical procurement of organs from the East. The enormous costs incurred from caring for people on the waiting list. Based with this substantial evidence, it seems that all these problems stem from the sad fact that there are not enough kidney organs being donated and a stigma attached to the actual HIV disease itself. But then we must ask ourselves "Why are the compassionate members of our society not co-operating, and not donating their gift?" Firstly, there is a huge lack of awareness regarding how to go about organ donation (Neyhart, 2007). This highlights the fact that the general public are ignorant about the benefits of organ donation, and the methods of donating. Patients With Human Immunodeficiency Disease should have equal Access to Kidney transplantation. Not following this concept would indicate that discrimination is taking place. Discrimination in this day and age is also illegal. A life is a life and if the HIV sufferer is in need of a kidney then he/she gets it regardless of what other may feel.

The facts speak for themselves. Each day, 120 people are added to the ever-growing organ waiting list and kidneys are really in short supply. An astonishing 41% of these unfortunate people, that's about 50, will die due to the lack of donor organs in circulation. This translates to a phenomenal 18,000 deaths per year. 18,000 deaths. Surely you cannot fail to see the enormous injustice incurred here. Many of these deaths were HIV sufferers who could not get kidney transplantation (Goss and Adam-Smith 2006).

This inequality between supply and demand has led to many illegal practices and the unethical procurement of organs from other, poorer countries. This has occurred in 2 main ways (Goss and Adam-Smith 2006).

Illegal organ trafficking from the poorer Eastern countries to the West.

Increasing Medical tourism where wealthy people travel to the east, and search for a donor there.

However, in such cases, one cannot be sure whether donor organs have been legally obtained, or whether potential donors have been compelled by forced of blackmail. Is it, right, that the poorer people should be obliged to sell their body as a direct result of their dire social circumstances? And what of those who cannot receive the organs they so desperately need? People with kidney failure have to rely on kidney dialysis machines, are forced to lead very limited and unfulfilling lives (Neyhart, 2007). Kidney Dialysis also costs the healthcare system huge amounts per year, as dialysis machines require constant maintenance and replacement.

Transplant tourism, where patients travel to foreign countries specifically to receive a transplant, is poorly characterized. This study examined national data to determine the minimum scope of this practice. U.S. national waiting list removal data were analyzed. Waiting list removals for transplant without a corresponding U.S. transplant in the database were reviewed via a data validation query to transplant centers to identify foreign transplants. Additionally, waiting list removal records with text field entries indicating a transplant abroad were identified. We identified 373 foreign transplants (173 directly noted; 200 from data validation); most (89.3%) were kidney transplants. Between 2001 and 2006, the annual number of waiting list removals for transplant abroad increased. Male sex, Asian race, resident and nonresident alien status and college education were significantly and independently associated with foreign transplant. Recipients from 34 states, plus the District of Columbia, received foreign transplants in 35 countries, led by China, the Philippines and India. Transplants in foreign countries among waitlisted candidates in the U.S. are increasingly performed.

Historically, doctors were thought reluctant to ask families of the deceased about the possibility of donating their relative's organs. However, Gentleman et al. found that in fact request rates were reasonably high such that the belief that a failure to request is the cause for organs shortage is no longer sustainable. Rather, the problem with the opt-in system is its inability to enforce deceased individuals' preferences because the family vetoes it, in part because they were never made known. For a grieving and bereft family, a request for organ donation is difficult to agree to because they can only guess at the wishes of the deceased and if there were any doubt at all, would not the natural answer be a rejection? If relatives had severe objections, they should be taken into account for to do otherwise raises the spectre of the swastika, but the point remains that by changing the default position of organ donation it is a veto clearly against the deceased's wishes, which would be rather more unlikely to take place than the current veto due to a simple lack of information. It is not that the PC system is ethically unsound (Hatfield and Walker 1998).

It can be argued that presumed consent is superior to the opt-in system because it truly ensures autonomy by giving effect to choices each person makes. It gives legal effect to individual autonomy and it ensures truly informed consent when accompanied by public education and information, instead of intuitive responses to organ donation. But one has to question how comfortable the deceased family will be when they come to realise that their relatives' kidney is being placed into someone who is HIV positive. This is likely to be an ethical and morale matter rather than a discriminatory one (Williams, 1999).

Nonetheless, some problems with presumed consent have been pointed out. Patient autonomy lies at the very heart of modern medicine and medical research. This is partly a reaction against medical paternalism and an increasing awareness of the integrity of the individual. It may be argued that a presumed consent (PC) system is paternalistic - but it concomitantly reinforces individual autonomy and preserves the dignity and integrity of the individual especially in comparison to, for example, an organs market. (Brooks).

McLean points out that underpinning the system of organ donation is the fundamental view that organ transplantation should be a gift relationship and should not be based on the type of disease a person has. This underlines that HIV sufferers are just as entitled to a kidney transplant as those who are looking for a heart transplant. John Morris doubts that proposals to change legislation to allow presumed consent to be introduced are likely to be publicly accepted. However, why is presumed consent any less a gift? It does not mean widespread harvesting of major organs. It means greater public awareness and individual choice that is made concrete.

In today's modern, the reality is that HIV / AIDS is at a crossroads where the economic and political niches of the contemporary modern condition provide both the possibility to raise scientific research in order to create a means of effective pandemic or the new religion of globalize capital may only serve as to extend HIV / AIDS to become the biggest social issue of all history. There is a huge issue with regards to donor transplantation and especially kidney transplantation. Unfortunately, some patients with Human Immunodeficiency Disease are denied equal access to kidney transplantation and the same priorities of other people who are suffering from other…

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