Alcoholic denied liver transplant – news?
Several media are carrying a story about a man denied a liver transplant because he’s a chronic alcoholic, and more or less implying this isn’t fair and that the health system has let him down. I mean, get the family photos, especially on CTV’s version.
I don’t want to be harsh, but I can see why doctors would be unwilling to undertake surgery on this man plus several of his relatives, if he has never been able to stop drinking, as it says in the articles. I don’t see where fairness comes into it. It’s common sense.
Also it’s a weird kind of journalism.
Myles 19:34 on 2022-08-11 Permalink
That’s always been the policy of every donor system I’ve ever heard of. There are a limited number of livers and surgeons who can transplant them, so they need to be given to people with the highest chance of successful transplantation.
Joanne 19:46 on 2022-08-11 Permalink
A transplant is not a cure. It is an ongoing treatment that requires extreme disclipline, lots of medication and frequent medical testing. The investment by the health community is extensive and lifelong. So no, they will not transplant someone who is high risk.
Blork 21:57 on 2022-08-11 Permalink
It might be different if the surgeons and support personnel were just sitting around wishing they had something to do. But the health care system here is in a permanent state of triage, so if you treat one person that means you’re not treating another. That makes it a game of “who is most deserving of this limited resource?”
OTOH at least one of the stories implies the drinking is a recent thing, and is self-medication for depression and insomnia. So you could argue that his treatment could be broader than just the physical liver issue. But that info purely anecdotal, from the family, so it can’t be taken at face value. And apparently he’s failed at rehab a few times (although rehab and mental health treatment are not the same thing.)
Tim 08:56 on 2022-08-12 Permalink
The CBC article makes an interesting point about the distinction live donors who volunteer to donate. If somebody wants to step up and help a family member, which appears to be the case in this story, why shouldn’t the medical community proceed? In this case, the person receiving is really not taking anything away from another person in need. I hope that the court case makes it to the Supreme Court.
Kate 09:41 on 2022-08-12 Permalink
Tim, as Blork points out, surgeons are busy and operating rooms aren’t just standing around empty. Taking a piece of liver from two or three people and inserting them into one guy is not going to be done in half an hour.
Also, even if they’re willing, you’re cutting into several healthy people and that isn’t without risk. At best, they will have to recover and in that time won’t be able to work or go to school. Yes, livers grow back but once again, there’s bound to be some extended risk for them, even if they say they’re willing to do it.
Doctors estimate risk and they also consider medical ethics. Balancing the risk to the patient and his relatives vs the likelihood that he’ll go on drinking and wreck this new liver in short order, the decision seems pretty clear to me. It’s not unfair to deny this procedure to someone for whom it is not likely to end well.
j2 10:59 on 2022-08-12 Permalink
Medical tourism will solve this problem.
Ephraim 11:06 on 2022-08-12 Permalink
I’ve known someone who had a transplant. You are on anti-rejection medications for the rest of your life, if it works. It’s not something that should be done lightly. Here is an article from 2020 on Canadian practices… https://canlivj.utpjournals.press/doi/full/10.3138/canlivj.2020-0005
Kevin 11:47 on 2022-08-12 Permalink
Canadians need to have a mature, wide-ranging discussion about healthcare, how it works, how much it costs, and about personal responsibility.
Putting someone in the ICU costs about $20,000 per day.
If you can’t get out of bed on your own, if you’re on 100% oxygen, if have half a dozen IV lines in your body, but you are insistent on leaving the ICU, the doctors and nurses will eventually stop arguing with you and wheel you to the front door of the building and leave you to your own devices.
Doctors and nurses can’t care more about your health than you do.
Blork 21:52 on 2022-08-12 Permalink
@Ephraim, for this particular guy the options seem to be (a) be on anti-rejection drugs for the rest of his life, or (b) be not alive. I don’t think he’s taking it lightly.
But that is an important point for people who are self-inflicting damage to their organs. A transplant is not an easy swap, and yes, you are on anti-rejection drugs for the rest of your life, meaning you are immune compromised for the rest of your life. (Anti-rejection drugs work by suppressing parts of your autoimmune system.)
Ephraim 18:56 on 2022-08-13 Permalink
@Blork – If you are still drinking when you need a new liver… you are taking it much too lightly.