Should a 22 Year Old Alcoholic Get a Liver Transplant?

UPDATE: The 22 year old patient that I speak of below passed away.  Very, very sad.

There is an interesting debate in London right now as to whether or not a 22 year old alcoholic deserves a liver transplant.

First a little background.  The patient in question started drinking alcohol with friends when he was 13.  Now nine years later he has the worst case of cirrhosis doctors have ever seen in someone this age.

As you can imagine livers are in short supply, with 400 people dying on the waiting list last year in Britain alone.

Doctors at University College Hospital in London have given Reinbach the most advanced therapies, including a one-off treatment with an artificial liver from San Diego, Calif. But all have failed and they believe only a transplant will save him.

The problem is they don’t want to give him one.  In Britian you must be able to prove that you can be abstinent if you want a transplant due to excessive drinking.  Wait, WHAT?  How on earth can you prove that you will be abstinent?  Supposedly they send you home for a period of time and if you don’t drink you are getting your liver.  Fantastic, but what about the day after the patient gets home, is abstinence still a requirement?

Look, maybe this person can prove that they will stay abstinent, although I have no idea how.  This raises a fascinating question.  Should we be able to decide who gets organs that they need or should everyone go into the candidate pool?

Aren’t we heading down a really slippery slope here?  If a smoker needs a new lung do they have to swear they won’t smoke again?  Easy answer says yes, however, what if they start back up again?  Can we take the lung back?

Let’s look at something more murky.  What if a person needs a new heart, must they swear off hamburgers for the rest of their life?  What if they are poor and can only afford junk food?

Can you see the problem here?  What if I live under a power line and get liver cancer as a result, must I move?  What if I can’t?

Is it possible there may be some class warfare here?

In the case of this young man, he began drinking at 13, well before he could possibly understand the consequences of his actions long term.  I am all for personal responsibility here, however, 13 is way too young to grasp the consequences of hardcore drinking.  Of course the question that you could ask is where were his parents???  His mom reports that she was working full time and had no idea that he was drinking this heavily.

All of this makes me nervous as we go forward with our healthcare debate in this country.  How are going to reasonably make the decisions on who gets what when it comes to health care.  Should we spend less on the 86 year old grandmother when trying to save her life as opposed to the 34 year old?  If we think a person is likely to keep smoking should we really try to save their life if they have a heart attack?

I wish I had the answer…I do have an idea though.

I will write about how I think health insurance should be address in the next couple of days.  It is too big for this post.  Sorry for the tease!!!

I am very interested in how you think Britian should proceed, please comment below.

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