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March 28, 2014 | Posted By Marleen Eijkholt, PhD

Amber is a 70 year old woman. She is doing poorly. She has metastasized cancer, multiple co-morbidities and a pressure ulcer. Apart from her ulcer, she has no acute care needs that condone her to the hospital. Some predict that she is likely to pass over in 3 months. With the right type of medications Amber could go home. However, the pressure ulcer medications that she needs cost about 200 dollars a day and she does not have the right type of insurance to pay for this. As a result, she is confined to a hospital bed. 

Amber has always contributed diligently to society. She worked from age 17 in a bank and paid her taxes diligently. Amber and her husband, who died 3 years ago, raised 3 children and lived in a town upstate New York. They used to take holidays on the West-Coast, where Amber has a family summer home.  This house belonged to her great grand-mother and has been in her family for 120 years. All of Amber’s family is attached to this house.

Amber does not want to report the family house as one of her assets to pay for her ulcer pills. Why should her care have to mean that this historically important house would be lost for her family and siblings? During discussions about her case, many express dismay that she does not want to report her house to pay for her care. If you have a house to pay for your care, you should give it up, especially when you are occupying a scarce hospital bed. 

I always thought about a right to health care as connected to homeless or poor individuals, unable to purchase health care. Arriving from Europe, I always thought everyone should have health care, at least to a basic standard. But my thoughts never went any further. Never did I think about individuals who had some assets but would lose these assets to purchase pills or other types of care. I had never heard of medical bankruptcy or understood what this meant. I saw the right to health care as a matter of ensuring that everyone had right to access to health care, and I never thought about its scope; the right to health care as a product where you can earn claims, but if your money finishes there are no more claims, even if they are basic claims. You can be a productive member of society, work all your life and contribute to society, but still would risk exhausting ‘basic’ treatments in health care. You need to sacrifice your family’s summer house in order to get basic care. 

Amber is occupying a hospital bed, because she does not want to give up her family home. Is this unfair or unjust; not morally right? If so, do you think that her refusal is unfair, in seeking to retain her family’s house, or is it unfair because she has no right to health care?    

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.
1 comments | Topics: Distributive Justice, Fairness

Comments

Athene Aberdeen

Athene Aberdeen wrote on 04/02/14 9:55 AM

A useful case for debating the right to health care. Can Amber exercise her autonomy and insist on going home because she knows that she can never in conscience give up the family home? What is the role of family members here in helping to meet some of the medical expenses? This is a case that comes out of a developed society with sophisticated and expensive treatments. In the third world such prolongation of life is not countenanced nor affordable.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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