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Health care is fraught with difficult ethical dilemmas. How much should a brake medicine cost for a seriously ill child if the effect is limited? And how much tax money is it reasonable to spend on new, effective but expensive cancer drugs? These kinds of decisions are made repeatedly in the regions.
It is not uncommon for them to appear unnecessarily emotional, but they defend themselves on the grounds that health resources are finite.
Another type of ethical problem refers to the distribution of health resources among different groups. Should healthcare be seen as an insurance benefit for Swedish citizens and people with the right of permanent residence or should it be free for all?
Since 2013, adults who are in Sweden without a permit have the right to “care that cannot be delayed” (while children have an unlimited right to receive care). The meaning of this wording is broader than most people imagine and includes, among other things, dental care and contraceptive advice.
The Swedish Board of Medical Ethics (Smer) now wants to clarify the remaining question mark and demands that the undocumented and asylum seekers have the right to a transplant in Sweden on the same terms as everyone else. Everything else would be to qualify human dignity, writes Representative Smer in a discussion article.
Today, different practices are applied to transplant centers in the country. Some operate on children but not adults. Others want to make sure that the home country can provide the necessary aftercare in the future before having an operation.
Is Smer to be understood to mean that every person who goes to Swedish territory should have the same right to organ transplantation if necessary as Swedish citizens?
These cases are, of course, extremely comforting, and in the Aliens Act there is already the possibility of obtaining a residence permit for medical reasons.
At the same time, both the availability of organs in Sweden and the future demand for this advanced form of care to be released must be taken into account. Already today there is a great shortage of organs. In October 2020, 844 people lined up to get one or more new organs and, on average, nearly one person died a week on the waiting list.
It is easy to think that the undocumented are a limited group that has lived clandestinely for many years in the country after the decision to reject it. In fact, the shadow society is huge and the ways to get here are many.
Some travel here without a visa from Georgia and Ukraine, but once in Sweden, they seek asylum and / or work illegally. Others come here from Central Asia on Polish or Latvian visas. Others follow the smuggling route across the Mediterranean.
Should Smer be understood to mean that all people entering Swedish territory should have the same right to an organ transplant if necessary as Swedish citizens and people with a permanent residence permit?
If there is a problem with medical tourism, the rules may need to be changed, Smer reserves the right. The principle of human dignity invoked was apparently not set in stone after all.
In fact, such a crucial question cannot be taken so lightly. Why should we have an ethical council if difficult but obvious conflict of objectives arise?
