Freethought & Rationalism Archive

brighid · 07-23-2003, 11:41 AM

Michelle,

I would say the problem is with the current state of the system. If funds weren't cut and money wasn't so tight I don't think much attention would be paid to an inmate getting an organ transplant. I feel the focus should be put on the irresponsible moves made by our government that harm the most vulnerable in our society.

I have a hard time with the alcoholics on the bottom of the list, as I thought alcoholism was a disease and not simply a choice. I realize it isn't a disease like others that cause kidney failure but if the judgment for such a thing is made because alcoholics did this to themselves sort of reasoning ... well I am bothered.

Many people die after transplantation and receiving a transplant is no guarantee of longevity. It is quite possible any other donor of the same organ would have died as well, but no one can know that.

I really, really hate the idea that poor people don't get help because they do not have medical insurance. The cost of transplantation is more then some people make in a lifetime. Again, it is the fault of the system and the poor state of healthcare in this country.

It is definately a complex issue.

Brighid

Viti · 07-23-2003, 11:49 AM

The problem with the alcoholics receiving liver transplants is that it is difficult to tell who is truly "recovered". Recipients must be fastidious with their health and medications for the rest of their lives and part of their work up includes questions about their dedication toward keeping their new organ healthy for as long as possible. There are not enough organs to go around to risk a liver to someone who may just kill it with drinking or drug use as well. Harsh, I agree, but I don't know any better way currently. I support cloning research for transplant organs as that seems the best answer for the future.

scigirl · 07-23-2003, 12:17 PM

Here are some ethics web sites which address this issue:

http://www.wma.net/e/policy/wma.htm

From the World Medical Association:

Quote:

Justice in Access to Organs and Tissues

The WMA considers there should be explicit policies open to public scrutiny governing all aspects of organ and tissue donation and transplantation, including the management of waiting lists for organs and tissues to ensure fair and appropriate access.

Policies governing the management of waiting lists should ensure efficiency and fairness. Criteria that should be considered in allocating organs and tissues include severity of medical need, length of time on the waiting list, and medical probability of success measured by such factors as type of disease, other complications, and histocompatibility. There should be no discrimination based on social status, lifestyle or behaviour.

Special appeals for organs for a specific recipient raise concerns of justice since the recipient may not be the most appropriate to receive the organ based on explicit criteria (e.g. severity of need or probability of benefit).

In limited circumstances (e.g. between family members), directed donations of organs and tissues may be appropriate, providing that the decisions to donate are fully informed and voluntary.

Payment for organs and tissues for donation and transplantation should be prohibited. A financial incentive compromises the voluntariness of the choice and the altruistic basis for organ and tissue donation. Furthermore, access to needed medical treatment based on ability to pay is inconsistent with the principles of justice. Organs suspected to have been obtained through commercial transaction should not be accepted for transplantation. In addition, the advertisement of organs should be prohibited. However, reasonable reimbursement of expenses such as those incurred in procurement, transport, processing, preservation, and implantation is permissible.

Here's some other links about organ donation and ethics:
http://www.ama-assn.org/ama/pub/category/2068.html

My one experience with organ denial was this gentleman who needed a heart/lung transplant, and he said he was off his drugs. However his urine tested positive for cocaine, so basically we didn't put him on the waiting list.

This issue is hairy - and there are a lot of things to think about. I've seen patients who have receieved heart or heart/lung transplants that are still fucking smoking. Does it absolutely piss me off? Yes. But - who gets to be the behavior police? If someone is still drinking, then obviously they should not get a new liver. But not all cases are as clear-cut, and where do we draw the line?

I for one would like the following things happen so that this issue of "deservedness" is minimized:

1) Come up with small incentives to donate organs - discounts on funerals, or something to at least help the family out.

2) Encourage would-be donors to actually discuss this issue with your family. I don't care how many organ donor cards you fill out - if your family doesn't know about or agree with your decision, you will not be an organ donor.

3) Make stem cell research legal for chrissakes!

Well that's my 3 cents -

scigirl

ooh_child · 07-23-2003, 12:24 PM

If the system were changed, as some have suggested, so that the default is donation after death, then would there be enough organs to go around?

MHB

Rusting Car Bumper · 07-23-2003, 12:26 PM

One thing about organ transplants is that quality of life is not necessarily improved after transplants. In fact, this goes for many modern medical procedures.

We have learned to keep people alive but we haven't caught up to simultaneously making sure quality of life is there as well.

DC

brighid · 07-23-2003, 12:53 PM

Quote:

The problem with the alcoholics receiving liver transplants is that it is difficult to tell who is truly "recovered". Recipients must be fastidious with their health and medications for the rest of their lives and part of their work up includes questions about their dedication toward keeping their new organ healthy for as long as possible. There are not enough organs to go around to risk a liver to someone who may just kill it with drinking or drug use as well. Harsh, I agree, but I don't know any better way currently. I support cloning research for transplant organs as that seems the best answer for the future.

I agree and it is certainly problematic and sadly there aren't enough organs to go around. Agreed on the cloning/stem cell research as well.

Brighid

brighid · 07-23-2003, 12:54 PM

scigirl,

Thank you VERY much for the great links, perspective, suggestions and information. I agree with all you said.

Brighid

Viti · 07-23-2003, 01:06 PM

Quote:

Originally posted by DigitalChicken
One thing about organ transplants is that quality of life is not necessarily improved after transplants. In fact, this goes for many modern medical procedures.

We have learned to keep people alive but we haven't caught up to simultaneously making sure quality of life is there as well.

DC

Quality of life is usually greatly improved...what information did you use to form this opinion?

Bad Kitty · 07-23-2003, 01:36 PM

Quote:

uality of life is usually greatly improved...

Yeah, I thought so too; i.e.; a kidney transplant is an improvement over life with dialysis...

Michelle

Viti · 07-23-2003, 01:51 PM

My kidney recipient looks better, feels better, can do sports and travel again...he was barely existing on dialysis.

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07-23-2003, 11:41 AM	#21
brighid Veteran Member Join Date: Apr 2001 Location: somewhere in the known Universe Posts: 6,993	Michelle, I would say the problem is with the current state of the system. If funds weren't cut and money wasn't so tight I don't think much attention would be paid to an inmate getting an organ transplant. I feel the focus should be put on the irresponsible moves made by our government that harm the most vulnerable in our society. I have a hard time with the alcoholics on the bottom of the list, as I thought alcoholism was a disease and not simply a choice. I realize it isn't a disease like others that cause kidney failure but if the judgment for such a thing is made because alcoholics did this to themselves sort of reasoning ... well I am bothered. Many people die after transplantation and receiving a transplant is no guarantee of longevity. It is quite possible any other donor of the same organ would have died as well, but no one can know that. I really, really hate the idea that poor people don't get help because they do not have medical insurance. The cost of transplantation is more then some people make in a lifetime. Again, it is the fault of the system and the poor state of healthcare in this country. It is definately a complex issue. Brighid

07-23-2003, 11:49 AM	#22
Viti Contributor Join Date: Apr 2001 Location: Down South Posts: 12,879	The problem with the alcoholics receiving liver transplants is that it is difficult to tell who is truly "recovered". Recipients must be fastidious with their health and medications for the rest of their lives and part of their work up includes questions about their dedication toward keeping their new organ healthy for as long as possible. There are not enough organs to go around to risk a liver to someone who may just kill it with drinking or drug use as well. Harsh, I agree, but I don't know any better way currently. I support cloning research for transplant organs as that seems the best answer for the future.

07-23-2003, 12:24 PM	#24
ooh_child Regular Member Join Date: Jul 2003 Location: Tehachapi, CA Posts: 190	If the system were changed, as some have suggested, so that the default is donation after death, then would there be enough organs to go around? MHB

07-23-2003, 12:26 PM	#25
Rusting Car Bumper Banned Join Date: Jul 2002 Location: U.S. Posts: 4,171	One thing about organ transplants is that quality of life is not necessarily improved after transplants. In fact, this goes for many modern medical procedures. We have learned to keep people alive but we haven't caught up to simultaneously making sure quality of life is there as well. DC

07-23-2003, 12:54 PM	#27
brighid Veteran Member Join Date: Apr 2001 Location: somewhere in the known Universe Posts: 6,993	scigirl, Thank you VERY much for the great links, perspective, suggestions and information. I agree with all you said. Brighid

07-23-2003, 01:51 PM	#30
Viti Contributor Join Date: Apr 2001 Location: Down South Posts: 12,879	My kidney recipient looks better, feels better, can do sports and travel again...he was barely existing on dialysis.

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