Sebelius Responds to Dying Girl ‘Someone Lives and Someone Dies’

Discussion in 'Too Hot for Swamp Gas' started by diehardgator1, Jun 4, 2013.

  1. dynogator
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    dynogator Well-Known Member

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    It's not a hypothetical. There's certainly a 13 year-old on the list. Also, 12, 14, 15 year- olds. If a face were to be put on the other child who would be bumped, would it change your mind?
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  2. G8trGr8t
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    G8trGr8t Premium Member

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    That evidence based policy is based on 15 to 20 year old science though. Do you think that medicine may have advanced since then?
  3. gatorman_07732
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    gatorman_07732 Well-Known Member

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    Nobody is saying that she should jump anyone one the list, but rather just to put her on it. That is a false argument.
  4. GatorBen
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    GatorBen Well-Known Member

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    It's not a matter of "maybe we can do it" though. When you're trying to maximize successful outcomes (what UNOS's allocation policies are charged with doing) it becomes "which present's a greater risk of complications, implanting an adult lung into an adult or attempting to cut it down to make it implantable into a ten year old?"

    I would assume that the answer to that one is still pretty clear cut, but if the science is divided UNOS should actually examine it and see if a policy change is needed and would be consistent with their goals of minimizing organ waste and maximizing successful transplant outcomes rather than just yelling "good enough, time to change right this instant because we really want this particular girl to live even if there's still a real possibility that this transplant would give someone else a much better chance at living!" Which is, of course, exactly what they were doing.
  5. 96Gatorcise
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    96Gatorcise Well-Known Member

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    if put on the adult list it is believed she would move to the top by passing adults who need a lung as well and who would possibly have a better survival rate.

    Becuase she is a child and has an INCURABLE disease.....

    Lung transplants are the most difficult of organ transplants, and children fare worse than adults, which is one reason for the existing policy, said Dr. Arthur Caplan, a bioethicist at New York University Langone Medical Center.
    He called it troubling, and perhaps precedent-setting, for a judge to overrule that medical judgment, and predicted a run to the courthouse by patients who don't like their place on the waiting list.


    Read more: http://www.foxnews.com/health/2013/...t-in-girl-lung-transplant-case/#ixzz2VRifzQKh
  6. mdgator05
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    mdgator05 Premium Member

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    Then what is the issue with leaving her on the pediatric list? If she shouldn't jump anybody on the adult list, she would still functionally be at the same place she was before, getting the organ if nobody on the adult list could get it. That is what a position on the top of the pediatric list grants her.
  7. mdgator05
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    mdgator05 Premium Member

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    Actually, about 8 year old research was already linked to this thread.

    http://www.math.utah.edu/~adler/myreprints/liou_etal2005.pdf

    If there has been new evidence disputing this claim, it can and should be part of a review. Do you know of any? I asked for some earlier and nobody responded.
  8. mdgator05
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    mdgator05 Premium Member

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    The issue is that you appear to have compassion when faced with an issue, ie when you can see a picture of the girl. However, others have compassion for the other people on the list and indeed for the person who died and donated that organ in an attempt to help others live. That is why we have rules for transplants, to ensure that this gift (and it is a gift) is used in the best medical manner possible to save the most lives.
  9. mdgator05
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    mdgator05 Premium Member

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    So we should also be able to buy organs then, correct? Because I would certainly be willing to do that if it was what was needed to save a loved one's life. Maybe the way we operate this system shouldn't be built on the idea of what people would do to save their loved ones, because I could imagine some pretty horrific things that people would do in that situation.
  10. icequeen
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    icequeen Well-Known Member

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    There are so many children and adults who are on transplant lists. Each one is a face, each one is a story, each one is someone's child, parent, sibling...what makes this kid different is the parents sued and got her picture everywhere to pull at the heart strings.

    These guidelines are in place for a reason. The inverse of this will be what if they give her the adult lungs, she has complications and fully rejects them and becomes ill again, or worse, dies? Do the parents then sue saying, "well, she should've gotten pediatric ones". What if they get the lungs and with the cavity size difference the lungs don't fit? This is not something you can just trim and make it fit. I mean, why bother having pediatric lists versus adult lists then, if they're so interchangeable?

    Does this now open the gates for adults on transplant lists who are difficult to match to then go on the pediatric list if there's an organ that matches THEM?

    Since insurance companies are VERY specific on guidelines, since she's not getting a pediatric transplant, does this mean the insurance company can deny coverage, since she's not getting an "approved" treatment? Did they even think of that?

    I'm a mother, and I can't imagine what they're going through. But this...exception...for just one person...ANY person...is going to open a floodgate of litigation and policy fights that will be a nightmare for a lot of people, including UNOS.
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  11. cjgator76
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    cjgator76 Well-Known Member

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    I hope that the courts exercise a lot of caution before diving into this area. Whatever flaws the system may have now, I can't see how allowing people to sue their way to the head of the line will improve things.
  12. 96Gatorcise
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    96Gatorcise Well-Known Member

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    the tragedy in your scenario is 2 lives will be lost, the girls and someone else's on the list those lungs could have gone to.
  13. icequeen
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    icequeen Well-Known Member

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    What it will become is what UNOS was formed to AVOID, a basic pay-for-organ system where those that had the most resources got the organs they needed and the average Joe was out of luck. UNOS was meant as a database to pick people by symptoms and severity of disease, not socioeconomic status or whether they were good looking, etc. This circumvents the spirit of UNOS and organ donation, actually, since the idea is to donate your organs so ANYONE can live, not those that people think are worthy of living over others.
  14. gatorman_07732
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    Buy organs? Where did I say that?
  15. GatorBen
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    GatorBen Well-Known Member

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    I think the point was to respond to your "wouldn't you do something if it was your daughter" that of course, we would all do all sorts of things to try to save our own children, but that doesn't make them good ideas when you look at the system as a whole.
  16. icequeen
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    icequeen Well-Known Member

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    You talked about "by any means necessary." The argument can be made that people are willing to do anything for their children. They are willing to die for their kids, defend them with any means, and to their last breath try to save their dying child. UNOS was a way for a system that takes emotion OUT of the equation and treats the patient as a patient.

    What happens if there's a child that is in the foster care system and has no one to fight for them "by any means necessary"? Does that mean they get different treatment? That if they're dying, too, they don't deserve the same than some kid who has parents that can fight publically and use the legal system to help them?

    ANY parent would do what they could, and therein lies the problem. Because when you take UNOS out of it, you're going to have parents who are sick enough, who are crazy and desperate enough to kidnap other kids, to go through medical records to find matches - they are not going to CARE what happens to them as long as their child is okay. And if they get caught, they'll ask for leniency saying, well my kid's sick, wouldn't YOU do ANYTHNG for your kid?
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  17. dynogator
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    dynogator Well-Known Member

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    I didn't know this, so I looked it up:

    "It is also possible for living donors to donate a lung or part of a lung, part of the pancreas, or part of the intestines. Although these organs do not regenerate, both the donated portion of the organ and the portion remaining with the donor are fully functioning."

    I would guess everyone in the girl's family has been tested, and no match found. I wonder if they ever transplant just one lung, that would save twice as many people.
  18. GatorBen
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    GatorBen Well-Known Member

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    Maybe one of the MDs on the board can definitively answer, but my impression is that single lung transplants are typical except when there's a medical reason for needing a double.
  19. gatornana
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    Another parent has sued and won....here we go:


    http://vitals.nbcnews.com/_news/201...es-suit-for-lung-transplant-gets-on-list?lite
  20. icequeen
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    icequeen Well-Known Member

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    Yeah, this is what people just didn't want to (and some still don't) listen to. They've opened Pandora's box with this whole thing. Now parents who want to save their kids (Or adults even) better have good lawyers in their back pockets.

    And again, no one's answered the cost/insurance question. An insurance company can rightly say that the "gold standard" is a pediatric transplant. They can argue that this is "experimental" because it's NOT the standard of care and therefore don't have to cover it. So who's left to cover that? People already have to get help/raise funds for services above an insurance cap. And now they've spent plenty of money on lawyers, too, so what do they want next? The government to step in & pay for it, too?

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