Family says DeKalb teen being denied heart transplant

In My Humble Opinion (IMHO)
#1

Local story here in Atlanta, but I suspect it will grow.

Doctors won’t give a 15yo a new heart because they say he’s not eligible.

Parents say it’s because of his grades and police record.

I don’t know the details of his medical care, but suppose he would take his meds.

Can we keep a person off a transplant list if they’re a criminal? An inveterate risk taker? Skydiver? Drug addict? Drug dealer?

If I need a liver, I’ll have to wait. Mickey Mantle? Drank his to shit, and gets a new one in one day.

Larry Hagman, and David Crosby were alcoholics, but they got new livers.
George Best got one too, and started drinking again. Died a couple of years later.
I watched Saving Private Ryan last week. When Tom Hanks is shot and dying, he tells Ryan “Earn this.” and dies. Clearly his rescue and subsequent life were paid for by the sacrifice of others, and he damn well better be worth it. Be good. Be valuable. Do good. Earn this sacrifice - don’t waste it.

So, here’s the question of the day…

What do transplant recipients owe to society, if anything?

#2

Yes to all. Can and do.

Just don’t waste a precious resource. Beyond that it’s all bonus points.

#3

Reading that article, it sounds to me like the doctors don’t think the kid will take care of himself post-transplant. That is a plenty good reason to deny someone a transplant, because why waste a precious resource?

IMHO, the family complaining about bad grades and crime is just them blowing smoke. They’re unhappy with the doctor’s decision (understandably) and want someone to blame other than their precious little boy. Which, again, is understandable, but not the criteria for a transplant.

#4

No; actually, giving a heart to somebody who is unlikely to properly follow up with their own maintenance, and therefore will probably die anyway, is a death sentence for another recipient. Two deaths, one wasted heart.

#5

Not to mention that Dick Cheney got a heart transplant at age 71. But people who destroyed their organs through alcoholism or drug addiction (meth will destroy your kidneys) must, according to most transplant centers, have become sober prior to their terminal illness. They are also placed towards the bottom of the list.

Mickey Mantle’s transplanted liver had cancer in it that was not detected prior to surgery, and because he was immune compromised, it flared up and spread.

Anyway, a 15-year-old cannot be forced to take medication, and if he’s demonstrated that he won’t take care of himself, at any age, he shouldn’t do it. I wonder what’s wrong with him, and if he became that way because of his refusal to take care of himself. BTW, this is not uncommon with Type 1 diabetics.

I did rotations on an organ transplant unit, and there was a patient who rejected his kidney because he deliberately threw up all his meds. :eek: I wondered how he passed the psychiatric evaluation.

#6

Kid has a serious heart condition, a history of non-compliance. By which I assume medical non-compliance, not taking his meds and not taking care of his health as his doctors told him.

Family making a ruckus with all the smoke and veiled accusations they can? Understandable.

Should we fall for it? Not a second.

Look on the bright side: if that kid dies, all but his heart can be used for other people on the transplant list.

#7

I thought his original liver had cancer, which had spread and resurfaced after his transplant. He didn’t get cancer from the transplanted liver, but from the removed liver.

#8

Well look at that, the li’l Tin Man might get his wish after all!

#9

Goddamnit. :mad: Should be a medical decision.

#10

It’s still no guarantee that he’ll get one. Chances are, with his track record he’ll be placed at the bottom of the list anyway.

#11

This is a perfect chance for a news followup in a year or two. They family can crow (or not) about how well (or not) their son is(n’t) doing.

#12

Article says:

#13

No, that’s not the case. Organ transplant recipients are not considered as donors. The anti-rejection medications are pretty harsh and can cause organ damage as a common side effect (ironic, yes).

#14

Presumably, s/he meant that if he did not have a transplanted heart, the rest of the organs would be fine, NOT that they could donate organs after transplant.

#15

I’m not comfortable with the whole idea of a a kid this age being required to prove compliance. He’s 15. How much of a history of independent medical decisions should he have had here?

#16

Americans are, by nature very compassionate, but sometimes that compassion is misplaced. This is a tough case because like Sugaree, who knows what a 15 yr old will do? Race may or may not be a factor here. Being poor (?) may also be an issue for some.

Young people should be a higher priority than old geezers because they potentially could become contributing members of society.

I’m a diabetic and was told that I’m not a candidate for a pump because of my age and other medical complications and though it sucks sticking myself with a needle 5 times a day I understand the logic. But it wasn’t the doctors who made the determination, it was the insurance company. I had to fight for infusion therapy because of the cost, $14,000 per treatment, and having a disease that has no known cure.

Medical care is rationed all the time. I’m just glad I’m not the one denying treatment that in effect is signing someone’s death warrant.

#17

That is why eligibility should be decided by an independent commitee. If it became made on a person by person basis there is too much room for manipulation on an emotional level, as has already been shown to be the case.

BTW, is it ethical to spend many, many thousands of money on one person when that money could help hundreds of people with simpler diseases/ conditions?
Different if the person is paying all the bills themselves, but public money should, IMO, be used for the benefit of as many people as possible. Problem nowadays is that people think that death can be cheated, when of course it is inevitable.

#18

If countries with UHC tried to follow that line of thought to its ultimate consequences, they’d explode socially. Both things need to be equilibrated: in the end, the question is what benefits society most, and sometimes what benefits society most is having super complex treatments available for those who need them.

#19

An important issue is they’re not really just deciding if they’re going to give this person an organ. It’s not like they have one lying around going to waste.

What they’re really deciding is who gets the next available organ. If they give a heart to Anthony Stokes then they’re not giving it to somebody else.

So it’s not asking “Do we give a heart of Anthony Stokes? Yes or no.” That’s a pretty easy question to answer. But the real question is “Who do we give this heart to? Anthony Stokes or John Smith.” and the answer to that question is a lot more difficult.

#20

While medical compliance is very much a factor, what are termed “social issues” carry weight here, too. If you’re talking about someone rebellious and non-compliant outside of medical issues, particularly if there isn’t a long history of chronic illness in which to demonstrate medical compliance, that could also be seen as a reason to strike the patient from the list.

In other words, this is a medical area in which you can be judged by non-medical behavior.