Friday, May 23, 2008

Organ allocation is not based on need

A common criticism of LifeSharers is that we might prevent an organ from going to the person who needs it the most. But organs are not given to the people who need them the most. We've written about this before here and here. More evidence of this is provided in an ABC News story about Jonathan Simchen, who was turned down by two transplant centers because he uses medical marijuana.

Virginia Mason Hospital in Seattle is one of the transplant centers that turned down Mr. Simchen:
Alisha Mark, a spokeswoman for Virginia Mason, would not discuss details of Simchen's case because of medical privacy regulations, but said that "any patient who smokes any product -- tobacco, cloves, medical marijuana -- would be precluded from receiving a transplant here."
At Virginia Mason, even tobacco use disqualifies you from getting a transplant, no matter how bad you need one.

Why does this kind of thing happen? Here's one possible explanation from ABC's story:

Transplant centers tend to be very careful because they survive financially based on the number of successful transplants they do, explains Maxwell J. Mehlman, director of the Law-Medicine Center at Case Western Reserve University. "They use a screening process to avoid people who might be failures and they look at several factors from drug use to having a support system," he said. "It has actually been a source of bioethical controversy because it allows them to reject homeless people and people who live alone. In some cases, it's a backdoor way of rationing based on social worth and lifestyles."

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