His liver, ravaged by hepatitis C, is failing. Without a new one, his doctors tell him, he will be dead in days.
But Garon isn't getting a new liver. He's been refused a spot on the transplant list, largely because he has used marijuana, even though it was legally approved for medical reasons.
Many people think organs are given to the people who need them the most, and that organ allocation is based only on objective medical criteria. Mr. Garon's story shows that's not how it really works:
Because of the scarcity of donated organs, transplant committees such as the one at the University of Washington Medical Center have tough standards for deciding who should get them. Does a candidate have other serious health problems? Will he religiously take anti-rejection medicines? Is there good family support? Is the candidate likely to drink or do drugs?
This is the case nationwide, not just in Seattle:
The Virginia-based United Network for Organ Sharing, which oversees the nation's transplant system, leaves it to individual hospitals to develop criteria for transplant candidates. At some, people who use "illicit substances" — including medical marijuana, even in states that allow it — are automatically rejected. At others, such as the UCLA Medical Center, patients are given a chance to reapply if they stay clean for six months.
It's a myth that organs are allocated to the people who need them the most. It's a myth that only objective medical criteria are considered when allocating organs. Under the University of Washington Medical Center's standards, the person who needs an organ the most won't get one if he doesn't have good family support. Under UCLA Medical Center's standards, the person who needs an organ most won't get one if he's used marijuana in the last six months.
Critics of LifeSharers, which allocates organs first to registered organ donors, say LifeSharers doesn't give organs to the people who need them the most. That's a straw man. The national organ allocation system doesn't give organs to the people who need them the most. Critics also say LifeSharers introduces non-medical criteria into organ allocation. That's another straw man.
It's easy to see why it might not always make sense to allocate organs based only on need and objective medical criteria, given that there is a severe shortage of transplantable organs. Should an organ be given to someone who won't benefit from it because he has other serious health problems? Should an organ be given to someone who won't take the anti-rejection medicines needed to maintain the organ after surgery? Should an organ be given to someone likely to damage it by drinking or doing drugs?
Organs are allocated with questions like these in mind in order to maximize the benefit from transplanted organs. LifeSharers suggests adding one more question to the list: Is the person who needs the organ a registered organ donor? Adding this question to the list will increase the number of organs donated. That will save more lives. The overriding goal of our transplant system should be to save as many lives as possible.
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