PainRack wrote:The thing is, there's way too much misinformation out there and in the comments about that page. Its ludricious to think that his low grades had any effect on his transplant list and it smells to me that this emerges from the stage of denial for grieving relatives rather than an actual hospital decision.
That was my first thought as well.
Similarly, run in with the law would only have factored in if it was for drug abuse and the like, and then, there should also be legal issues with opening up a juvenile record.
IF he actually did get wheeled into the ER at some point with an ankle monitor it could have biased someone. That's not
supposed to happen but it does. On the other hand, given the very limited supply of donor organs and the much greater demand for them whether or not the recipient is able or willing to comply with the post-transplant requirements is a huge deal. They don't give you an anklet for "low grades" and it's certainly possible he was involved in something quite serious. While juvenile court records are usually sealed medical issues are an area where a judge could be persuaded to release the information.
Anyone here willing to comment?
Thought I already was.
The story shows a clash between various issues in the US.
There is, of course, the question of bias. Racism and classism isn't supposed to occur in medicine but as medicine is supplied by fallible humans it's a possibility. That doesn't mean it's occurring in this particular case but the question will be raised. The black community is keenly aware that black people are less likely to get organs than white people, but what isn't always understood is that this is an area of medicine where race - or, if you prefer, ethnicity - really does count. Proper organ matching means matching certain compatibility factors and people of the same general descent are more likely to have similar markers. It's not impossible for people of disparate background to be matches but it is much less likely than people of similar background. There are times when a white donor can supply a viable organ for a black (or Asian) recipient but it's much less common than matching with someone of the same race. There are a numerous groups in the US, from major celebrities to individual families, trying to increase organ donation from minorities but the brutal fact remains that simply being a numerical minority reduces your chances of getting a transplant simply because the potential pool of donors is smaller.
There is the issue of "non-compliance", which is a slippery one. It may have nothing to with his life outside the hospital - we are talking about a seriously ill 15 year old young man who might well be angry and who might have acted out while in the hospital. I have NO way of knowing what is behavior has been
this is PURE speculation but a patient who, say, heaps verbal abuse on the staff, throws things or otherwise displays signs of anger or rebellion is NOT going to help his bid for a transplant. Because the supply of organs is so small compared to demand the transplant teams are only going to pick the most compliant patients and that pretty much means following doctors' orders will little to no backtalk or questioning. Other typical teen misbehavior that could get him bumped is ANY alcohol, drug, or tobacco
use (aside from any drugs ordered by the doctors, or course), staying out past curfew. Any sign of rebellion risks bumping you off the recipient list.
Which brings us to medical shortages and rationing. Americans don't like the notion of rationing in any form (never mind that
de facto we ration medical care based on personal financial resources), even less in medical matters. However, the brutal fact is
there aren't enough organs to go around. That means
someone has to decide who gets one and who doesn't. That is supposed to be decided on purely medical criteria, however, given that there is a shortage transplant centers feel that not only must they find a good match but they must choose recipients based on who will be able to get the most use out of it. Fact is, if you don't comply with the post-transplant medical requirements that organ is going to shrivel up and die. The basis of using compliance as a criteria is that organs should go to those most likely to take their pills and otherwise follow doctors' orders because they'll get the most out of the new organ. To some extent, people on the transplant list are in competition with each other to demonstrate how good a patient they are. The general public does NOT like this fact and will happily try to find blame or unrelated bias, scream bloody murder, make demands, and take hospitals to court in attempt to actual this horrible little fact of life and death:
there are not enough organs to meet demand.
Which leads us to the media. If all else fails families attempt a saving throw by going to the media.
Of course the sick person is an angel, or at least not as bad as some make him appear, and will be a good boy and do whatever is required - that's necessary to sell the public on this person. It becomes eligibility by charisma, not medical criteria. While that
can help if money is an issue, sometimes raising the needed funds for otherwise eligible patients, it won't actually make some other people more suitable as candidates. The family went to the media because they're desperate.
The transplant center may have caved because bad publicity can interfere with their mission. Getting hauled into court over this can certainly impair their mission. The over-riding motive of a transplant center is to save lives and it would not surprise me if they make a compromise to keep the program going as smoothly as possible. I don't
know that that happened here but it's possible.
Additionally, there are reasons the wealthy - of any ethnicity - are more likely to get a transplant in the US than poor people. For one thing, when it comes to transplants money counts. If you can't pay for a transplant in the US - if your insurance won't cover it, if you don't have insurance, and you don't have the money to pay out of pocket from your personal finances for the treatment you will NOT get it. The rich can pay, it's that simple. Another reason is that those of modest means only register at one transplant center. The US (actually, all of North America) is divided into regions for transplant purposes. This has to do with geography and transport time. Organs are first offered within the region they are harvested, only if there are no matching donors within that region are they offered outside it... if there is sufficient time to transport the organ. Which there may not be. The very wealthy - like Dick Cheney - can get on the list within
multiple regions because, in addition to simply being able to afford (through either good insurance or personal wealth) a transplant they can
also afford to charter a personal air ambulance to meet a new organ halfway. The more regions you can register in the better you odds of getting a new organ.
Finally, let's not discount political realities. Darth Cheney may be hated and despised by many, but he is still a man of influence. While I have absolutely no proof such a thing it is conceivable that he pulled strings to get his new heart and/or made promises along the lines of continued or additional funding to such programs. It's not medical criteria, but it's conceivable that someone thought the good of a continued or expanded transplant program outweighed the bad of tweaking the list to favor a sick old man of great political influence.
Yes, a lot of the above is speculation but it's all stuff that crosses my mind
every time I hear a story like this young man's. It would be nice if there were ample new organs for all who needed them and money was never a consideration but that's not reality.