Thursday, 30 July 2009

Picking and Choosing

Here's a story about a 22 year old man who was an alcoholic, and was refused a liver transplant because the doctors thought he would ruin it.

Now the story highlights some issues, obviously the shortage of organs and therefore, who should get them and then, how do we pick and who to choose to refuse? On what grounds?

I read some people discussing this on a blog, and some saying this was pretty unfair because what about, say, fat people with heart problems, do they get refused heart transplants. In fact, lots of medical problems are self-induced so do we all get refused help if it's self-induced?

One person said that she thought the refusal was disgusting because she hated it when doctors 'played God'.

(Actually, I thought doctors played God all the time by treating patients, or that's one way of seeing it. Leaving them to whatever nature and God intends happen to them instead of giving them medicine, hooking them up to machines and cutting them up and and replacing organs would be more in line with not playing God, once you've taken a person off where they've fallen off a cliff and started to patch up their bones and pump them full of chemicals and fought against Death, that sounds very much like playing God to me. Not that I think there is anything wrong with that. If I fell over and broke my leg I'd want a doctor to play God with my leg and patch it up, pronto!)

Anyhow, it does raise a difficulty of ethics, how to make such a decision, after all the decision has to be made somehow, whether it is a first in first served, or by the highest bidder, or assessed most critically, or whatever. You can't blame doctors for having to refuse someone, what are they meant to be, magicians who can yell a multiplying spell for livers?

Anyhow, I leave the thought with you and perhaps you can munch on a liver sandwich and think about it.


JahTeh said...

I read about this young man and the impression I got was that he was too far gone to benefit when the waiting list is so long. It's not just the transplant but the life after that is so complicated. The right diet and loads of pills to stop the body rejecting the transplant and that's for the rest of your life.
Having been in the position of having to turn off life-support, you really have to weigh up what kind of quality of life a person will have and if they'll cope with it.
Doctors have to do it all the time and I don't envy that part of the job.

Maria said...

Well, many idolise doctors and go on about how they must feel great, all the power for doing good but it has grave responsibilities. They have to make important decisions, they don't always get it right, and they have limited resources and while they save lives it can also mean that when they have to make a tough decision like this people turn on them which I think is very unfair. It is almost like they expect doctors to be able to do everything perfectly just because they are doctors.

If an accountant had to refuse to take on a client, or a restaurant decided they just couldn't serve people, or even if grocers altogether said they were out of eggplants for an entire season, we'd accept it as tough luck, and that the lucky few either got in quick or had money or connections or special traits, but when doctors say they have to be choosy and they are pretty much all out of livers and only a select few can get them, people seem to take it as malice or vindictiveness omn the part of the medical profession. In the end it may sound callous but they are providing services to people just like everyone else and they have limited resources and we arent' all equal in their eyes - some are more deserving, some can pay better, some have better cases, etc, and these can assess whether we get treatment better or faster.

That's life and it's the way it goes.