organ transplant question?

Question

if someone is on the list for an organ transplant, say a lung or a liver, and they are either a smoker or an alcoholic, and you KNOW that they wouldn't stop smoking or drinking, is it fair that they should receive an organ ahead of someone whose illness warrants their need for a new organ? should the person who abuses their body get a new organ before a sick person gets one, just because they are ahead on the list?

Answer 1

Most pulmonologists and gastroenterologists would not recommend a patient for a lung or liver transplant if they are still continuing to "abuse" the substance that got them there.
Typically patients with cirrhosis due to alcohol wouldn't get referred for consideration of a liver transplant until they have been sober for over a year, and are dedicated to staying that way...
If you are referring to the story of the tragic accident to the harvest team in Michigan, I had the same initial gut reaction on reading the story- a COPDer getting a lung transplant for smoking as opposed to say a patient with cystic fibrosis (an illness you are born with) getting a transplant. But, my wife reminds me, a portion of COPD is caused in America by inhaling smoke from wood burning stoves, there is the second hand smoke arguement, and America is all about second chances.
I'm sure a transplant surgeon, or specialist has a better Idea of the criteria that goes into dictating where you are in line for getting an organ- but the severity of your illness plays a significant role. You have to be very sick, like almost ready to die without the organ transplant, but not too sick to survive the surgery...and as you can imagine- it's a tough surgery. So there is a lot of "jumping around" on the list as patients decompensate while waiting.
One final thought. After the surgery and the new organ- you are not "as good as new". In addition to your new organ, you get a few new perscriptions for medications that will suppress your immune system to minimize the chance that your body will reject the organ. That's not quite like being a patient with AIDS...but it's along the same line. And needless to say, your life expectancy is extended by some years, but it's still not going to be anywhere near normal...

Answer 2

I believe that the organ transplantation system tries to be as objective as possible. The same argument for a alcoholic versus a non-alcoholic could be made for a rich person versus a poor person. There are other issues at stake here; for example, do you want hospitals making decisions on care based on your lifestyle? If I don't eat the best diet, should that make me less likely to receive a kidney if my current kidneys are failing?

This is really a question of bioethics for which there is no real answer. Is it fair? I don't think so. But I also don't want people making assessments of what care they are going to give me based on my lifestyle. So, personal freedom wins out for me and a "first come, first serve" organ recipient goes with the territory.

Answer 3

When patients are screened for receiving organ transplants, most are counselled on their habits (ie. smoking, alcohol). It is an ethical question with no right answers.
Look at the case of Mickey Mantle who probably received his liver transplant sooner than many people on the transplant list but abused his liver for years by drinking.
Or those who eat deathcap mushrooms and then require immediate liver transplants.

Answer 4

I was talking about this with some people online not too long ago.

"Should alcoholics get liver transplants?" from BBC News:
http://news.bbc.co.uk/1/hi/uk/3064167.stm

The flip side of this is: Should a person on a liver transplant waiting list be forced into AA? One such person, Clifton W. Kirton,
who objected to being pushed into a religious program was told by by Judy Stowe, Certified Chemical Dependency Counselor and coordinator of the Organ Transplant Chemical Dependency Unit at The Cleveland Clinic:

"If you think that's what Alcoholics Anonymous is all about, you're really missing the point. Religion has nothing to do with it. Your higher power can be anything. You are not being coerced. Your participation in A.A. is entirely voluntary. I must caution you, however, that your failure to internalize recovery concepts will place your transplant candidacy status in great jeopardy."

(Right, not being coerced, he could always chose death. Not religious? This matter has come up before a few higher courts, the Second and Seventh Federal District Courts, The New York State Court of Appeals, and the Supreme Court of Tennessee; every one of these courts determined thaty AA was at least "religious in nature" and it was a violation of the Establishment Clause for judges to forced people to attend what amounts to religious services.)

He wrote:
"When I protested that if she insisted on forcing me to jump through these ridiculous hoops to prove myself worthy of organ transplant recipient status, there were other avenues available, she replied that she was aware of these other avenues, but that I was too early "...in recovery" to start getting "creative" with the process, this despite my having consumed no alcohol for a year before she ever laid eyes on me. The fact is that this author is not "in recovery" never has been "in recovery" and never will be "in recovery." Like the vast majority of people who give up bad habits, I simply stopped drinking when I recognized it was imperative to do so. Any association between the disease/recovery paradigm and the realities of addiction is spurious."
http://www.morerevealed.com/articles/kirton.jsp

Answer 5

Good Point!!! I personally don't thnk it's fair but those are the rules. Also one could argue this. What if someone needed a lung transplant because they breathed in second hand smoke all their life because of let's say a job. and after receiving the transplant they have to go back to that job and breathe in all the smoke again. Is that fair either?

Answer 6

chronic smokers and drinkers are not allowed to recieve transplants. If a drinker can't stop drinking, why would they be allowed to get a new liver? Transplant are for those who have lvied a healthy life, but through various illnesses can't survive with their own organs.

Answer 7

Well - one thing I know.... I'll bet YOU'RE sure that they are having sex with their boyfriend or girlfriend. You assume that - right? It was kind of creepy the way you assumed that 19 year old was sleeping with the 16 year old - when you answered her question about how she would know when he wanted to marry her - but whatever.

And just so you know - people who are not taking care of themselves are not on the top of the list when it comes to getting organs. Everything is taken into account when it comes down to the decision of who will and won't be given organs.

Answer 8

the way you correlate organ transplants with Christianity? Doing sturdy and looking out after the temple of God (the human physique) isn't against Christianity. yet killing yet another human for doing it incredibly is going to be a strict NO. ./

Answer 9

We are Not judge or jury in life_death or the choices one makes How They Live THEIR lifes.Before or after proceedure.Or when their name-blood types-proper matchs occur for anyone waiting on organ transplant.I was thinking of selling an organ[or should i say for a donation]Does this make Me wrong too?

Answer 10

It might not seem right, but in this day and age
we really can't discriminate like that..

Just like in a store, you take a number.. first come, first served.