According to the American Liver Foundation, in 2005, 1,848 people died because they were unable to get a new liver in time. Right now, about 17,000 people are on the national liver transplant list, waiting for new organs that may never come. Of course, this scarcity of donated livers brings to question which groups of people should be eligible to receive a transplant – one of the most controversial of which is alcoholics.
In a recent study published in the New England Journal of Science, the researchers state that, “Reluctance to perform transplantation in patients with alcoholism is often based on the view that they are responsible for their illness and are likely to resume alcohol use after transplantation.” Currently, the policy is that patients with severe alcoholic hepatitis must refrain from drinking for 6 months before they can be put onto the transplant list. So, should alcoholics be eligible for liver transplants? Should they be given a second chance after their own actions ruined their liver? I believe the answer is “Yes”.
It is understandable why many people are against the idea of using a limited supply of organs to help people who have shown little care for their body in the past, but alcoholism is not just some life choice or addiction – it is a disease, and it should be treated as such. For instance, a liver disease expert from Columbia University, Dr. Robert S. Brown Jr., asserts, “Alcoholism is a disease, and it should not be used to exclude patients from transplantation”. Thus, alcoholism should be treated like any other disease, such as cancer, or other mental disorders like schizophrenia when an individual is being considered for the transplant list. The current policy is that patients with untreated cancer or mental disorders that prevent the individual from taking care of him/herself are ineligible for the transplant list until they have been treated and cleared by a physician. Following this reasoning, the current policy on alcoholism makes sense – after the patient has been “treated” for alcoholism, and has refrained from drink for 6 months, he/she should be eligible to be on the transplant list. Some might say that the alcoholics should stay sober for a longer period of time before becoming eligible, but this is quite unreasonable seeing as 70%-80% of the patients who don’t get a new liver die within 2 months.
Moreover, even if the alcoholic is at fault it is not as if we deny treatment to others just because their habits caused their medical problem; we don’t deny extreme sports enthusiasts treatment when they break their bones, nor do we ignore the numerous medical problems of smokers (which incidentally is not a disease but rather an addiction).
The second argument against alcoholics is that if they get a new liver, they will eventually relapse and destroy another organ. However, in the above mentioned study conducted in France and Belgium, researchers found that of the 26 alcoholics who received new livers, 20 of them were still alive 6 months later and in the coming years only 3 of them relapsed. Admittedly, the sample size is relatively small, but the statistics are about equivalent to the general survival rate of 75%. Furthermore, the chance of relapse should not preclude alcoholics from getting transplants since patients who had cancer can also “relapse” after the transplant, and sometimes the liver disease returns after the transplant anyways.
Therefore, because alcoholism is a disease, alcoholics should be allowed a second chance with a liver transplant as long as they demonstrate that they can remain sober for 6 months. Due to the limited number of organs available, choosing people who “should” receive transplants will always be very controversial, but we should not preclude entire groups and condemn them to death.
1 comment:
Good, not sure the athletics comparison really works but rest is strong
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