A Pertinent Pause

This week, I was poised to write another lighthearted post about my training exploits. I had a gym anecdote to share (one involving the apparent performance of a fellow gym-goer, blasting show tunes from his iPod and making interesting use of the body balls in one exercise studio, to the delight of those who had gathered there for a class). I had a cryptic/inspiring yoga instructor quote to share. But alas, those things will have to wait.

Yesterday, it was widely reported by popular and medical news outlets that a panel of healthcare experts from the United Network for Organ Sharing made public a new proposal for ranking those in line for organ transplant. If adopted, the proposal will replace the current "first come, first served" policy for with one that makes kidneys preferentially available for younger patients who are expected to live longer.

My initial response to the proposal was positive; after all, it seems logical that those who are "graded" highly according to the new algorithm will get the most--in terms of longevity and productivity--out of the distressingly limited number of organs available. I still believe that to be true. However, the lifespan of a kidney need not be so simple as the one it is presumed to have by the new proposal.

Consider this: a 20 year-old dies tragically in a motorcycle accident. His family chooses to donate his organs. Two patients are medically qualified to receive the donor's kidneys. One is 52 years-old, diagnosed with stage I hypertension two years ago, the father of four children ranging in age from 13 to 24 and currently covered by private health insurance. The other is 25 years-old with seemingly no other co-morbid conditions, no children, and is unemployed with no insurance coverage. It seems obvious that the 25 year-old would live the longest if he receives the newly available organ. Or is it? It is my firm belief that before measures are adopted that will make it more difficult for the 52 year-old hypertensive father of four to receive a life-saving transplant, legislators should take a good, long look at the programs in place to ensure that the kidney gifted to the equally worthy, uninsured 25 year-old will live out its full potential.

It's still taboo to talk about decisions like this one. No one wants to make the judgment that denies someone new life. But sadly, these are the kinds of choices we're left with when demand so obviously overwhelms supply. Proposals like the one put forward by the panel sound logical and fair, until you're the one shunted from the top of the list to receive an organ. Disease doesn't strike in a systematic fashion. Not everything happens for a reason. It is my sincere hope that the same concentrated effort that went into writing the current proposal will be applied to coordinate new, inventive ways to expand the supply and long-term viability of organs.