Monday, December 20, 2010

Arizona organ transplant policy and global norms

Reading Marc Lacey's article, "Transplants Cut, Arizona Is Challenged by Survivors," in Sunday's New York Times brought out the contradiction between Arizona's policy and global norms on transplantation.

Arizona has decided to cut Medicaid funding for transplants. That decision in all likelihood affects a lot of potential transplant recipients because if you're that sick, you're probably not working and if you're not old enough for Medicare, that means that you probably end up on Medicaid. In short, if you are blessed with insurance or personal wealth, you can have an organ or tissue transplant in Arizona. If not? Tough luck. Hope you had a nice life.

But the World Health Organization's Guiding Principles clearly proscribe this policy. Guiding Principle 9 is:
The allocation of organs, cells and tissues should be guided by clinical criteria and ethical norms, not financial or other considerations. Allocation rules, defined by appropriately constituted committees, should be equitable, externally justified, and transparent.

To be fair to the State of Arizona, lawmakers received a report from state health officials stating that transplants "were rarely successful." The problem is, that information just isn't correct. According to Lacey's article, "The cure rate for bone marrow transplants cited in the report to the Legislature was either zero or 7 percent . . . But transplant experts put the actual survival rate, based on national studies, at over 40 percent."

I find it morally abhorrent that some bodies (those owned by people lucky enough to have good health insurance) are "deserving" of life saving medical treatments while others (the ones relying on Arizona's Medicaid system) are not.

And on a personal note, I am extremely fond of one particular bone marrow transplant recipient. I am very happy that she's in that 40% of survivors.

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