Should drug abusers and alcoholics get livers?

[tjones80]

I was reading about the death of Lou Reed. He ruined his liver through drug and alcohol abuse, then got a liver transplant last June, at age 70. Apparently it didn’t go well because he died.

I guess a lot of organ transplant recipients in some way contributed to their predicaments, but the drug and alcohol abuse especially irritates me, especially since Medicare foots the bill.

Well I don’t believe that organ transplants should be done for any reason on adults. I can understand a child could benefit and live a long life. But it costs $100,000’s of dollars for a organ transplant and the cost outweighs the benefit for an adult. That money could be better spent on prevention and other people that have curable diseases. The American taxpayer paid for Reed’s transplant through the Medicare system. These kind of operations that are done at the end of a person’s life is what costing the taxpayer so much money in Medicare.
For example every year the Medicare system pays for heart surgeries for 1 million elderly when 80% of them die within six months of the procedure anyway.

 

[robwar]

Well I don’t believe that organ transplants should be done for any reason on adults. I can understand a child could benefit and live a long life. But it costs $100,000’s of dollars for a organ transplant and the cost outweighs the benefit for an adult. That money could be better spent on prevention and other people that have curable diseases. The American taxpayer paid for Reed’s transplant through the Medicare system. These kind of operations that are done at the end of a person’s life is what costing the taxpayer so much money in Medicare.
For example every year the Medicare system pays for heart surgeries for 1 million elderly when 80% of them die within six months of the procedure anyway.

So what are you saying then, if you are a certain age we should just let them die? I think when we start making judgement calls on who should live, who should get what and where, we become the nazi type society and it becomes the government that then decides who should live or at least worthy of living and then who should die. That becomes a kinda sick society. I’m not sure why this guy got a liver or even who paid for it. When people are claiming that this was paid for by tax dollars, where is proof for that. Liver transplants are considered highly experimental and usually NOT covered by insurance. Are you saying that after a certain age someone shouldn’t get medical treatment? What age is that in your mind? should it be 60 or 70 or 80? You made a statement that 80% of the elderly heart surgeries die in 6 months, where is your proof for that? site your source.

 

[robwar]

OMG, okay, just have them shut down the thread then. I happen to be interested in medical ethics and sorry I brought up the subject. Good grief… Sorry if I didn’t make a more general title. There are a lot of facets of organ donation that are interesting.

It is one thing to ask a question, it is another thing to ask a loaded question which is what yours was. You were making a judgement call on why this guy got a liver transplant who in the past abused drugs and now is dead. Your own views that this shouldn’t have happen came through and the issue of organ transplants is bigger and broader than this old rock star and Dick Chaney. It’s a judgement call on who should live or die and honestly I think implying that someone shouldn’t get medical treatment based on things in the past which none of us know fully or completely is skating on thin ice. God doesn’t treat us that way. Jesus healed those that came to Him with no strings attached. Should Jesus not heal the hundreds that came to Him for healing because they might not really follow Him? Should we even have age limits on medical treatment. God help us if we end up going down that slippery slop where not God but the government is deciding who is worthy and who isn’t.

 

[tjones80]

So what are you saying then, if you are a certain age we should just let them die?

Yes, If you are elderly and have major organ failure or in such bad shape you are going to die shortly any way you should be made comfortable, but the State should not spend tens or hundred of thousands of dollars in a vain attempt to keep a person alive. Death is a natural part of life and we must accept that. While Catholic teachings condemn euthanasia there is nothing saying we must bankrupt the state to keep people near death alive.
Presently the United States spends billions of taxpayer Medicare dollars trying in vain to keep elderly people on the edge of death alive.
The CBS news show 60 Minutes spot lighted this issue last year.

 

[robwar]

Yes, If you are elderly and have major organ failure or in such bad shape you are going to die shortly any way you should be made comfortable, but the State should not spend tens or hundred of thousands of dollars in a vain attempt to keep a person alive. Death is a natural part of life and we must accept that. While Catholic teachings condemn euthanasia there is nothing saying we must bankrupt the state to keep people near death alive.
Presently the United States spends billions of taxpayer Medicare dollars trying in vain to keep elderly people on the edge of death alive.
The CBS news show 60 Minutes spot lighted this issue last year.

Ok so do to money, we should let people die based on their age? I am sure that 60 minutes here is not exactly a pro-christian pro-life media outlet and anyone can manipulate the facts to make well meaning people like yourself think that it is ok to withhold life saving medical treatment which leads I’m sure into supporting Obama care and it’s death panels. God help us.

 

[tjones80]

Ok so do to money, we should let people die based on their age? I am sure that 60 minutes here is not exactly a pro-christian pro-life media outlet and anyone can manipulate the facts to make well meaning people like yourself think that it is ok to withhold life saving medical treatment which leads I’m sure into supporting Obama care and it’s death panels. God help us.

People die of natural causes. If your 70 years old you don’t need a liver transplant. I support putting a $100k lifetime cap on Medicare. We can’t afford $1 trillion+ in Medicare expenses each year for people that are dying of natural causes. We are all going to die and we must accept that fact.

 

[robwar]

People die of natural causes. If your 70 years old you don’t need a liver transplant. I support putting a $100k lifetime cap on Medicare. We can’t afford $1 trillion+ in Medicare expenses each year for people that are dying of natural causes. We are all going to die and we must accept that fact.

what an attitude towards our elderly and our sick.

 

[tjones80]

what an attitude towards our elderly and our sick.

What is wrong with that? I’m elderly and I know I’m going to die. I won’t be bankrupting my family to try and stay alive a few days more in pointless medical procedures. Like I said a $100k lifetime cap per person for Medicare is fair and will provide basic health care to a person. It will be up to each one of his to plan our final days.
However, we can afford to provide unlimited medical care to the elderly if we raise the medicare payroll tax to about 10% per taxpayer. With the baby boomers retiring now the Medicare costs will go into the trillions of dollars annually, if we don’t put a cap on per person care.

 

[KendraDZ1902]

What is wrong with that? I’m elderly and I know I’m going to die. I won’t be bankrupting my family to try and stay alive a few days more in pointless medical procedures. Like I said a $100k lifetime cap per person for Medicare is fair and will provide basic health care to a person. It will be up to each one of his to plan our final days.
However, we can afford to provide unlimited medical care to the elderly if we raise the medicare payroll tax to about 10% per taxpayer. With the baby boomers retiring now the Medicare costs will go into the trillions of dollars annually, if we don’t put a cap on per person care.

100K lifetime cap per person isn’t very much money, medically speaking. Also, you can pay x for a procedure, and I would be paying y for the same procedure. Did you know that a simple CT scan can cost almost 5000 bucks at some places? I had one last month and I will probably have another one when I go to the ENT next month. I’m not on my death bed, I’m 24 and healthy, besides my sinus problems I have been having. I’m not on Medicare, but I am on Tricare and the tax payer pays for 100% of my medical bills. If I have to have surgery because of my sinus condition, my 100 thousand cap would be close if not done with. That doesn’t include when I start having children, or anything else. I think it is ludicrous to put a 100k cap on Medicare recipients.

Also, it would probably be wise to start a new thread if you want to continue to discuss this, as this thread isn’t about putting caps on those who have insurance funded by taxpayers.

 

[tjones80]

100K lifetime cap per person isn’t very much money, medically speaking. Also, you can pay x for a procedure, and I would be paying y for the same procedure. Did you know that a simple CT scan can cost almost 5000 bucks at some places? I had one last month and I will probably have another one when I go to the ENT next month. I’m not on my death bed, I’m 24 and healthy, besides my sinus problems I have been having. I’m not on Medicare, but I am on Tricare and the tax payer pays for 100% of my medical bills. If I have to have surgery because of my sinus condition, my 100 thousand cap would be close if not done with. That doesn’t include when I start having children, or anything else. I think it is ludicrous to put a 100k cap on Medicare recipients.

Also, it would probably be wise to start a new thread if you want to continue to discuss this, as this thread isn’t about putting caps on those who have insurance funded by taxpayers.

Medicare recipients are 62 years of age and older. No one is talking about putting a cap on military medical benefits.

 

[KendraDZ1902]

Medicare recipients are 62 years of age and older. No one is talking about putting a cap on military medical benefits.

I didn’t say that. I was using it as an example, because it is fully funded by the government. Things can go wrong that doesn’t put someone on their death bed, but could definitely put someone over the cap you want them to have. A case of kidney stones and a 3 day hospital stay could cost Medicare $50,000.00. That doesn’t include routine check ups, or other exams. I know lots of people who are over 70 years old. If they had a lifetime cap of 100k, that could very well be long gone from age 62, without them needing transplants or being on their death bed. I think you are very wrong and maybe need to research more.

Let’s please get back on topic.

 

[lerapt78]

I believe that *active *drug or alcohol abuse is an immediate contraindication to liver transplantation. This is an unquestionably ethical decision, in my opinion.

However, I do believe previous drug/alcohol abusers should have the opportunity to be placed on a waiting list because if they have remained sober for a period of time it shows that they are committing to lifestyle changes that will reduce the likelihood of the transplant being “wasted”. How long that period of sobriety should be, I don’t know.

It’s never easy to place people into prioritization categories, but this is done in the healthcare field all the time. It occurs in general triage, with disaster casualties, etc. Unfortunately when there is a supply-and-demand situation, practical decisions have to be made to extend support to those who have the best survival chances.

 

[robwar]

I believe that *active *drug or alcohol abuse is an immediate contraindication to liver transplantation. This is an unquestionably ethical decision, in my opinion.

However, I do believe previous drug/alcohol abusers should have the opportunity to be placed on a waiting list because if they have remained sober for a period of time it shows that they are committing to lifestyle changes that will reduce the likelihood of the transplant being “wasted”. How long that period of sobriety should be, I don’t know.

It’s never easy to place people into prioritization categories, but this is done in the healthcare field all the time. It occurs in general triage, with disaster casualties, etc. Unfortunately when there is a supply-and-demand situation, practical decisions have to be made to extend support to those who have the best survival chances.

the person in question here has been sober and drug free for many years. this isn’t a question about some active user, but a former user and yes organ banks look into these types of issues.

 

[lerapt78]

the person in question here has been sober and drug free for many years. this isn’t a question about some active user, but a former user and yes organ banks look into these types of issues.

Oh, I didn’t realize the question was directed toward one person in particular - I thought he was just being used as an example. My post was more in response to the title of the thread, regarding the ethical question in general.

 

[JanetF]

To answer the original questions…There are guidelines in place through UNOS regarding lifestyle choices past/present. Current users/abusers would not be eligible.
Lou Reed could have had a family member who was a living donor (it’s available, albeit dangerous), as the liver regenerates. He could also have matched a liver that all the people above him did NOT match, which moved him to the front of the line. It does no good to be at the front of the line, if there are no matching livers for the patient. How do we know who paid for this?

The reason it seems that celebrities appear to get to the front of the line is that they make the news at all. You don’t usually hear about the every day donors/recipients, unless it’s a landmark medical case involving multiple donors, recipients, across differing states/hospitals, or it’s a landmark number of transplants.

I don’t know of very many elderly patients who receive anonymous donations. At a certain point, any surgery would be more dangerous than the possible benefit.

 

[vz71]

**

Should drug abusers and alcoholics get livers?

**My opinion, only if they are no longer such.

Of course, many alcoholics consider themselves alcoholic forever (difference being activity). But it is also that difference that I am thinking of.

There is little point in providing a transplant into someone that will continue to destroy the new organ the same way they destroyed the first.

 

[LeafByNiggle]

**

**My opinion, only if they are no longer such.

Of course, many alcoholics consider themselves alcoholic forever (difference being activity). But it is also that difference that I am thinking of.

There is little point in providing a transplant into someone that will continue to destroy the new organ the same way they destroyed the first.

How do you determine that an alcoholic is “no longer such”? Would you go by their stated intention? (I promise not to drink) or by a demonstrated period of abstinence? If it is a demonstrated period of abstinence, how long? Keep in mind that the patient may die waiting for a liver if the required period of abstinence is too long.

 

[vz71]

How do you determine that an alcoholic is “no longer such”? Would you go by their stated intention? (I promise not to drink) or by a demonstrated period of abstinence? If it is a demonstrated period of abstinence, how long? Keep in mind that the patient may die waiting for a liver if the required period of abstinence is too long.

Don’t know.
But that is slightly outside the scope of the original question.

When everything is boiled down to essence, it comes down to the honesty of the individuals involved. That is what it comes down to in court, taxes, and confession.

It is imperfect though, I would think honesty would be very hard when ones life is in the balance.

 

[Karrtel]

Physicians are supposed to heal and cure those who are sick. Patients fault is irrelevant including whether the person got their disease from drugs. People get heart disease from bad eating habits, but a doctor is supposed to heal/cure. Prison doctors treat criminals who committed the worst crimes.