A Wasted Organ Transplant: Why Patients’ Social History and Potential SHOULD Matter

Posted on May 11, 2015

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If you were faced with 100 dying people, and could only save 79 of them, how would you choose?

Back in 2012, 15-year-old Anthony Stokes was denied a lifesaving heart transplant. Doctors ruled him a bad candidate because of a “history of noncompliance,” meaning he was unlikely to follow doctors’ orders concerning medications and follow-up care.

His family, friends, and civil rights advocates loudly countered that the real reason that young Mr. Stokes was being handed this “death sentence” was because he was poor, black, and already had a history of run-ins with the law. Stokes himself pleaded with the public that he wanted to change his ways, to have a second chance at life. Tear-jerking stuff. Amid a media firestorm, doctors reversed their decision; Stokes got his transplant, and his second chance at life.

Fast-forward to just one month ago. As Sasha Goldstein reports in the New York Daily News, 17-year-old punk Anthony Stokes kicked in an elderly woman’s door in a home-invasion robbery, shot at her, fled in a stolen car, led police on a high-speed chase, hit and injured a pedestrian, hit another car, then plowed into a metal pole, killing himself.

Wow.  Way to blow that second chance.  I know there will be those who lament this “tragedy,” this loss of a young life; but the real tragedy in this case was the waste of a perfectly good donor organ that could have done a lot more good in some other patient.  The waste of some other patient’s life who didn’t get that second chance.

Harsh? Yep. But even harsher is the reality that in 2012, when this controversy erupted, there were 3400 people on waiting lists for heart transplants, but only 2000 procedures were performed. 331 people died while waiting fruitlessly for an organ to become available. One of those 331 might have been saved by the organ that instead went to a troublesome teen who had his whole life ahead of him, but through his own criminal choices, didn’t even make it to adulthood.

Should criminal history matter in making medical decisions involving scarce resources like human organs? A doctor commenting on the case said that patients would not be kept off the waiting list solely for prison time or bad grades, but “we would want to look at the entire picture.” So yes, doctors think that a patient’s personal history matters.

I would go even farther: I think that a person’s potential matters, too. Some will equate this to playing God, to providing medical care based on “worthiness,” rather than medical need; who are you to judge, they would ask.  But we’re not talking about readily available procedures like appendectomies, or basic care like vaccinations or orthopedics. We’re talking about human organs for transplant. It’s not a matter of denying anyone the procedure; it’s a matter of choosing the best candidates when there are not enough organs to go around.

Donor organs are in notoriously short supply, and every year, people die while on endless waiting lists. According to organdonor.gov, about 79 transplants are performed per day, but about 21 people die waiting for an organ that never becomes available.  If you were faced with 100 dying people, and could only save 79 of them, how would you choose?  Medical compatibility would have to be the first consideration, but then what?  The patients who have the loudest media team?  I think not.

You want to talk outrage? I’m outraged that someone else died because this kid happened to have noisy advocates to kick up a fuss over specious social issues, to make lurid accusations about doctors’ motives, and to sway the system based not on medicine, but on public opinion. Some anonymous heart patient was denied a second chance at life so this young kid could get his second chance. And he took that second chance and ran it right into a metal pole, threatening and injuring others in the process.  Bad choice, folks.

If my loved one were an organ donor, and I found out that my beloved’s death had merely made it possible for some budding young criminal to have two more years of crime-ridden life, culminating in a fatal wreck while fleeing police in a stolen car – I’d be pretty outraged at that, too.

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