If You Must Have a Failing Organ, Don't Go Taking Legal Pain Medication!

At least not the kind that gives you the munchies. If you do, they'll just let you die:

SEATTLE - Timothy Garon's face and arms are hauntingly skeletal, but the fluid building up in his abdomen makes the 56-year-old musician look eight months pregnant.

His liver, ravaged by hepatitis C, is failing. Without a new one, his doctors tell him, he will be dead in days.

But Garon has been refused a spot on the transplant list, largely because he has used marijuana, even though it was legally approved for medical reasons. [...]

With the scarcity of donated organs, transplant committees like the one at the University of Washington Medical Center use tough standards, including whether the candidate has other serious health problems or is likely to drink or do drugs.

Whole outrage here; thanks to commenter "sage" for the tip. Drew Carey explains the benefits of a liberalized organ market here.

Comments

Pre-Juanita | April 28, 2008, 4:02pm | #

Do Pot, Die Young, Any Questions?

Timothy Garon's Failing Liver | April 28, 2008, 4:03pm | #

His liver, ravaged by hepatitis C, is failing.

I served six years in the military, Does that make me patriotic? How many years did Cheney serve?

Juanita | April 28, 2008, 4:10pm | #

This descision seems a bit cruel, but keep in mind that alcohol and ilicit drugs damage the liver. Why should he get the transplant if he is just going to die from cirhosis from the pot and alcohol, when someone more deserving could get it?

Andy | April 28, 2008, 4:20pm | #

Pre-Juanita, my question is whether you're for or against that.

Real Juanita, what pot and alcohol? I think the point is that he only used marijuana to treat his condition, and wouldn't be a risk to do it after he got a new liver. As for alcohol, maybe that caused it, but you'd think almost dying would change your behavior.

Other Matt | April 28, 2008, 4:21pm | #

when someone more deserving could get it?

Depends how you define "deserving". He obviously needs one more if he's a hard drinker. What's chilling is for them, or you, to decide who is "deserving" and who isn't.

As an aside, I'd offer him joe's, but I've already used my gratuitous joe insult for today, so darn the bad luck.

J sub D | April 28, 2008, 4:22pm | #

*sigh* The War on Drugs Sanity.

libertarianjim | April 28, 2008, 4:23pm | #

University of Washington Medical Center use tough standards,

No shit! He's going to die.

Assuming anyone else is more deserving? Glad I don't have to play God (if you believe in that).

prolefeed | April 28, 2008, 4:24pm | #

Does pot smoking make a liver transplant more likely to fail? If so, I can see why he got bumped off the list. Did he have other risk factors besides the pot that made him a worse candidate than other people on the list? Did Matt Welch do any digging on why this person ranked lower on the priority list than the alternate candidates, or was it a lot easier to just be shocked -- SHOCKED -- that a drug user ranked lower than non drug-users on a transplant list?

Standard libertarian disclaimer -- wouldn't be an ethical dilemma if allowed bidding for organs, by both buyers and potential sellers, so people who need an organ could purchase one at market prices, instead of dying due to the decisions made by an organ transplant committee.

Paul | April 28, 2008, 4:26pm | #

Myself, I don't see the outrage here. Transplant committees have to make determinations about eligibility. It's neither here nor there that pot was legal for this patient. Alcohol is legal for everyone, but the use of it will also get you booted from the list.

I'm an RN, and I can tell you that libertarians don't run transplants committees. So if you think you might ever need a transplant, better snap to. The committee won't save you unless it thinks you're worth saving, and it won't think you're worth saving if you're using drugs. (And by the way, that practice is perfectly consistent with libertarian principles. The organs belong to the committee, which is entitled to make value judgments about who gets them.)

J sub D | April 28, 2008, 4:28pm | #

Juanita, How ya doing. I still got it bad for you. Why don't you ever answer me E-mails? We are destined to be together, living in marital bliss. Where do you work? What's your phone number? If I see any other men hanging around I'll get very angry. You wouldn't like me when I'm angry. E-mail me, we can set a "date".

XXX OOO ♡♡♡
J sub D

Andy | April 28, 2008, 4:31pm | #

So after actually reading it, he didn't abuse alcohol (good) and he smoked pot (neutral). So it comes down to others' judgements of his character.

"Marijuana, unlike alcohol, has no direct effect on the liver. It is, however, a concern … in that it's a potential indicator of an addictive personality," he said.

Yikes. Imagine if (more) people started to think of organized religion as a "potential indicator" of insanity.

Pre-Juanita | April 28, 2008, 5:04pm | #

Pre-Juanita, my question is whether you're for or against that.

It is important that this terminally ill patient pays the price for using a gateway drug like pot.

Otherwise, other terminally ill patients will want to use herion for pain or LSD to cope with death.

People must acknowledge that congressional leaders are far better suited to make end-of-life decisions than patients and doctors.

Danny | April 28, 2008, 5:29pm | #

Pre-Juanita = The Real Deal

/This post = isn't.

Dello | April 28, 2008, 6:04pm | #

Paul,
"The organs belong to the committee, which is entitled to make value judgments about who gets them."

Perhaps a libertarian minded person might argue that the organs actually belong to the doner, and that its only through bad laws that the committee exists at all.

KD | April 28, 2008, 6:11pm | #

Dello | April 28, 2008, 6:04pm | #
Paul,
"The organs belong to the committee, which is entitled to make value judgments about who gets them."

Perhaps a libertarian minded person might argue that the organs actually belong to the doner, and that its only through bad laws that the committee exists at all.

What you said.

(BTW spelling nitpick "donor")

Danny | April 28, 2008, 6:37pm | #

Dello and KD,

I agree, and this sets up what I have just realized as a libertarian distinction:

There are those that try to be libertarian in the laws as they currently are, which I might reefer[sic] to as the Realistic libertarian.

-And-

There are those that try to be a libertarian as they see the law should be, which I might call Idealistic libertarian.

Though I'm normally simultaneously realistic and idealistic, I normally find myself more in tune with the latter because the best solution is most often not currently allowable under law.

*Disclaimer*
This distinction has probably been made before, but I find this to be true in humanity in general, and not solely in libertarians or other political factions or organizations.

Hello9Kitty | April 28, 2008, 7:47pm | #

Drink!

Pre-Juanita | April 28, 2008, 8:26pm | #

Pre-Juanita = The Real Deal

Blushes

Dello | April 28, 2008, 8:54pm | #

Danny,

Great observation!! Permission to use it?

Thanks

Dello | April 28, 2008, 8:54pm | #

KD,
"(BTW spelling nitpick "donor")"

You're assuming I have brains...

Brian Courts | April 28, 2008, 9:12pm | #

And by the way, that practice is perfectly consistent with libertarian principles. The organs belong to the committee, which is entitled to make value judgments about who gets them.

By that reasoning the Soviet Union was perfectly consistent with libertarian principles as well. After all, the state owned the means of production so it was entitled to make value judgments about who got what and how much.

Paul | April 28, 2008, 9:56pm | #

Brian Courts,

Your analogy is flawed. The transplant committee is not the state. The committee is doctors, nurses and ethicists acting in their professional capacity. Even if we had an open market in which people could bid on organs, these professionals would still deny transplants to recipients deemed unsuitable. (Or at least they would in hospitals with reputable surgeons.)

Also, hard core drug users -- such as the type who contract hepatitis C from sharing needles -- often hail from the lower economic classes. Accordingly, even in an open organ market, they probably wouldn't be among the high bidders. (Pardon the pun.)

Chris Potter | April 28, 2008, 9:57pm | #

Keep in mind that because of this committee's decision, someone else who needs a liver to live will get one.

By that reasoning the Soviet Union was perfectly consistent with libertarian principles as well. After all, the state owned the means of production so it was entitled to make value judgments about who got what and how much.

I never realized that defending a property owner's right to decide what's done with his property entailed that one was a communist.

Brian Courts | April 28, 2008, 10:19pm | #

I never realized that defending a property owner's right to decide what's done with his property entailed that one was a communist.

Huh? That was hardly the point of my comment. The point was that if you simply assume "ownership" with some group as your starting point, saying its disposal of that property according to its wishes is "consistent with libertarian principles" is as true as it is trivial.

In other words, if you ignore how the property came to be owned, then sure, saying someone can dispose of it however he wishes is consistent with libertarian principles. But ignoring that asserted ownership sort of misses something important. In this case, the committees get to monopolize ownership by state fiat - nobody else can apparently own the organs (like the donor or his estate, perhaps). So just assuming ownership as your starting point and saying it is "consistent with libertarian principles" makes no sense.

Brian Courts | April 28, 2008, 10:28pm | #

Your analogy is flawed. The transplant committee is not the state.

First, your criticism is flawed. If I say A is to B as C is to D, it does not mean that A is the same as C, so whether the committee is the state or not is irrelevant. The point, as I stated above, is that if you ignore how they came to be "owners" you miss the part of the story that is highly relevant to libertarian principles. You have to justify that first, before simply saying they can decide to do what they want with their property.

Even if we had an open market in which people could bid on organs, these professionals would still deny transplants to recipients deemed unsuitable.

Really? Why don't doctors refuse to perform, say bypass surgery or kidney dialysis, on someone whose lifestyle they disagreed with? Do they refuse to perform any other surgery or medical treatment on patients they deem unworthy?

Chris Potter | April 28, 2008, 10:34pm | #

Given the, er, logistics of organ donation, the donor has moved beyond owning anything at that point. Giving ownership to the estate is really just as arbitrary, and it would also result in delays that would jeopardize the usefulness of the organ.

Seriously, people get denied for organs for all sorts of reasons (and this would happen in a free organ market as well). On the list of negative side effects of the drug war, this is about #6,549,334,102.

Chris Potter | April 28, 2008, 10:37pm | #

Really? Why don't doctors refuse to perform, say bypass surgery or kidney dialysis, on someone whose lifestyle they disagreed with? Do they refuse to perform any other surgery or medical treatment on patients they deem unworthy?

There's no limit to the number of surgeries doctors can perform.

There IS a limit on how many livers can be transplanted, and that limit is much less than the demand.

Chris Potter | April 28, 2008, 10:39pm | #

Also, if you're concerned about discrimination by the current organ committees, just wait till you get your free organ market, where donors can specify that only white heterosexual Christians can get their organs, regardless of medical necessity or probable success.

Brian Courts | April 29, 2008, 12:01am | #

There IS a limit on how many livers can be transplanted, and that limit is much less than the demand.

Certainly true. But my question about denying surgical procedures was responding to the claim that even if we had a organ market doctors would still refuse to transplant those they deem unsuitable. If you assume a workable market exists, as the claim does, then from the doctor's perspective it is simply a surgical procedure at that point and there is no reason to think a doctor would refuse to perform it.

Abdul | April 29, 2008, 7:37am | #

Mrs. Abdul used to be a doctor on a liver transplant team. While pot is legal under state law (still illegal under federal law), it is not medically advised for hepatitis C, and there's no evidence that it will make a transplant more successful, but some evidence that it will make it unsuccessful.

Danny | April 29, 2008, 11:00am | #

"Permission to use it?"

Surely :)

Steve Verdon | April 29, 2008, 2:00pm | #

As for alcohol, maybe that caused it, but you'd think almost dying would change your behavior.

IANAD, but I'm pretty damned sure you don't get Hep C via alcohol. Cirhosis, maybe...if you drink alot over an extended period of time, but not Hep C.

Paul, you are misleading with your assertions that the committee is "not the state". These committees are a product of various pieces of federal legislation, not spontaneous order as with the market.

Linky

To address the Nation's critical organ donation shortage and improve the organ matching and placement process, the U.S. Congress passed the National Organ Transplant Act* in 1984. The act established the Organ Procurement and Transplantation Network (OPTN) to maintain a national registry for organ matching. The act also called for the network to be operated by a private, nonprofit organization under Federal contract. The United Network for Organ Sharing (UNOS), based in Richmond, VA, administers the OPTN under contract with the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). OPTN committees and the OPTN board of directors develop policies and the UNOS, is responsible for coordinating committee and board actions.

Chris Potter,

Given the, er, logistics of organ donation, the donor has moved beyond owning anything at that point. Giving ownership to the estate is really just as arbitrary,...

Actually no, since we do that with other items the donor used to own. In fact, saying the estate owns the organs is quite consistent with how other property is handled.

..., and it would also result in delays that would jeopardize the usefulness of the organ.

Or maybe not. Once there is a market the estate (read families) might decide much more promptly and be more likely to sell such organs than they would in the absence of such markets. For example, a family reeling from the financial blow the loss of the primary income earner might see such a market as extremely beneficial and be more likely to donate. So your comment is at best speculation, as is mine. But given the historical evidence with how markets work at meeting increasing demands, I think I'll go with my view over yours.

There's no limit to the number of surgeries doctors can perform.

This is completely wrong-headed and highlights one of the problems with our health care system. We can't grow the world's food supply in a flower pot. You know that problem of decreasing returns to scale. It tends to set in eventually. Same thing with doctors. Given a finite supply of doctors at any given time there is a finite number of procedures they can do. Duh.

Also, if you're concerned about discrimination by the current organ committees, just wait till you get your free organ market, where donors can specify that only white heterosexual Christians can get their organs, regardless of medical necessity or probable success.

Oh please that can be easily remedied by having an anonymous buying/selling arrangement. You want the $$$ for the liver, you must agree to the anonymity clause. There done.

Dave D. | May 3, 2008, 10:54am | #

Timothy Garon died on Thursday, May 1.


http://seattlest.com/2008/05/02/medical_marijua_1.php