Might Need Asbestos Clothing for This One

Yesterday, I read a post by Trisha Torrey over at About.com's Patient Empowerment area. It was about the possibility of a convicted child rapist named Kenneth Pike being considered for heart transplant. She presented the issues and asked for readers opinions. This is my comment:

"One of the reasons I am a monthly support of Doctors without Borders is that they provide medical care without judgment. The person who needs it most is the person who receives the care and it doesn't matter if they are a child or a Janjaweed.

Do I like that a convicted child rapist is getting a heart transplant? No. But I don't believe that the organ transplant system should get involved in moral judgments about who deserves a transplant in any way other than the medical. Once you start judging whether someone is a "good enough person" to get an organ, it's a slippery slope. Who decides? By whose moral standards do we make this decision? There was a case several years ago of a young girl in Oklahoma who needed a kidney transplant - she met all the criteria in terms of health, ability to take antirejection meds, etc., but was ultimately denied. The only reason that appeared to have impacted that position was the fact that she had Down’s syndrome. Apparently, somebody who did not have an intellectual disability was deemed more "worthy" of a transplant. Was that right? Absolutely not. And if that wasn't right, then neither is denying this man a heart transplant.

Beyond that, not giving him a transplant is a death sentence, which means he might as well have received the death penalty for his crime. Is his crime punishable by the death penalty? No, it isn't. And therefore, the legal problems with denying him a transplant are huge.

I still don't like the idea, but I am an organ donor and I believe UNOS should make this decision the same way Doctors without Borders makes theirs: purely based on medical need."

Today's update mentions that Pike has decided against the transplant and makes the argument that since 90% of commenters were violently against him being even considered for the procedure, it might be time for the system to award transplants considering somebody's "goodness," basing decisions on some sort of point system. Not surprisingly, I don't agree, in part due to the reasons I've already mentioned - I don't think these kind of decisions should be based on emotion or morals beyond medical ethics. It means we get pushed up against very difficult situations and positions, but if we start awarding medical care based on someone's idea of moral fiber and character (again, who chooses the criteria?), it's a slippery slope right down into injustice. Medical decisions should not be made by popularity poll. Ideas of what is right/moral change - just because the majority of people agree with a certain position doesn't make it right. Think about this example: at the time when the law prohibiting interracial marriage in the US was abolished, 70% of the population was against interracial marriage.

And then there's another wrinkle on this point system. Where would it leave people with disabilities? For most of us, accumulating any kind of points might be difficult due to physical or intellectual limitations and social barriers. If transplants were to be awarded as a sort of reward for good behavior, the kind of behavior that can be measured by points assigned on a form, it could end up to some sort of eugenics project, couldn't it?

There's a slippery slope here and it goes pretty fast downhill.


Anonymous said…
Totally agree!

They do, I believe, however, include judgements based on expected compliance with after care....there are some people whom need a transplant who've demonstrated thatbthey can't or won't comply with vital treatments and behaviors....but, really, * that * aspect is, in many ways, medical.

Oh, and I am a survivor of childhood sexual abuse. I WANT it to be punishable with a death sentence, but thatnis wrong. That is why I dont approve of death sentences in general. But sexually abusing a child should be punishable right up there with murder.....esoecially since the repeat offense stats are so high.....
Anonymous said…
No asbestos needed, you are totally right. Let judges do the judging, not doctors.

Marie said…
Absolutely agree.  If they deny medical care based on "goodness" or ability, then denying because of age can't be far behind.  And I'm of an age where this might become an issue.  I also give to Doctors without Borders, for the very reason you stated.
Marie said…
I'm with you on what should be the punishment for sexually abusing a child.  There is no excuse for that.  I'm a little iffy on the death penalty, too, but not for cold-blooded murder and sexual abuse.
Adrienne said…
Oh hell no.  You're totally right about the slippery slope.  I mean, am I going to get passed over for a transplant b/c the other candidate goes to church and does more volunteer work than I do?  Medical merit is the only kind of merit this should be judged on.
Alex said…
Suit up.

We already make these moral decisions, that's why the guy was arrested, tried, convicted, and sentenced. It's not like a donor organ is going to waste if he doesn't get it, there are HUNDREDS of other qualified and appropriate recipients, most of whom have never raped children.

Raped. Children.

Laurie said…
I don't think this post could be approved upon in any way. It's the starkest examples that can help to prove an important point.
Laurie said…
that would be improved not approved. sorry.
AlisonH said…
It's a slippery slope, absolutely. And yet. Someone convicted of first-degree murder or clearly violent rape proven to be well beyond the he-said she-said, and especially child rape, should be at the very bottom of the list in my book. They've already torn out the hearts of their victims and every single person who ever cared about them.
Diane said…
Since this one is in my own front yard (so to speak), I have given it some thought.  I must say that I was relieved that Mr. Pike withdrew his name from the list as it does put off the decision.  However, I had come to the conclusion that it would not have been fair to deny him a heart transplant solely on his past crimes.  Do I think it's a "wonderful" thing that a convict can get a transplant?  No, I do not.  Until we change our laws to reflect that should you be convicted of a serious crime and are serving time that you are not eligible for transplants until you have served your time and are released, we have to continue to consider them in the same list as everyone else.  Is it a bit unfair to deny them if serving time?  Maybe, but then they are the ones who committed a crime.  

An even slippery-er slope is the one where you contemplate this:  Does someone who has pickled their liver due to alcohol abuse deserve a liver transplant?  Pretty much did it to themselves, didn't they?

All I know is that I'm glad that I do not have to be the one making the decision of who gets and who does not.

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