Jimmy is 58 year old Indigenous man who lives in a remote community. Jimmy receives dialysis 3 times per week, he knows that it is unlikely that he will receive a life changing kidney transplant, however, if he moved to the city, his chances would improve. Indigenous Australians living with renal failure should expect to wait longer to be placed on a transplant waiting list when compared to non-Indigenous Australians. This is true despite that fact that the incidence of end stage kidney disease (ESKD) for Indigenous Australians, especially in remote areas of Australia, is up to 20 times higher than comparable non-Indigenous peoples (Stumpers & Thomson, 2013). Devitt et al. (2017), in exploring Indigenous ESKD client’s views on transplant concluded that up to 90% of interviewees were interested in a transplant.
The transplant waiting list disparity has existed for 20 years and cannot be explained by the particular patient or disease related characteristics, however, the disparity is more pronounced for older people living in remote areas (Khanal et al., 2018). If Jimmy does make it onto the waiting list, the likelihood of him receiving a transplant is higher in the first year and is similar for non-Indigenous Australians; however, after the one year mark the transplant rate is significantly lower for Indigenous people (Khanal et al., 2018).
QUESTION ONE (1): Identify and discuss the relevant ethical and healthcare rights issues highlighted in this case.
Tara, a 15 year old girl approaches a health professional and seeks assurance from the health professional that her conversation will be kept confidential. The health professional assures her that unless there are compelling reasons ie. that the public will be at risk of harm, that the conversation would be confidential. Tara proceeds with her request for the ‘morning after’ pill as she is concerned that after having unprotected sex with her boyfriend that she may be pregnant. Tara is not taking regular oral contraceptives. Tara shares that her parents (who access the same health service) are ‘very religious’ and ‘don’t believe in premarital sex’, hence her seeking reassurance about confidentiality. Tara further states that her parents would be ‘disgusted’ if they found out she was seeking the morning after pill and would disown her. Tara has researched social media and online materials and has determined that there are no negative short (apart from a potential headache) or long term health consequences for her if she takes the pill. She tells the health professional, who is legislated to administer the ‘morning after’ pill, that “one of her friends has had the morning after pill and she was fine”, and she wants to have it too, just in case.
QUESTION TWO: What are the legal and ethical principles raised in this case? Are there multiple perspectives to consider? Give reasons (drawn from the literature) for your answers.