Reflections on health ethics in the news.

It was reported recently that a 36 year old woman died of liver failure while waiting for (hoping for) a liver transplant.  She was apparently denied a transplant because of her history of alcohol use and “minimal abstinence outside of hospital.”  Please see the attached story for details.

https://apple.news/AUbDaIwz7QGGF3bKMxTDimw

This brings to mind another story published a little over a year ago of Mark Kingwell a Toronto philosopher who also suffered liver failure as a result of alcohol use.  (the article is called : “And then everyday: reflections on a life of drinking” available to “Globe and Mail” subscribers).

The two stories raise a host of issues.  The first is a puzzle about the extent to which “values” inform (or should or should not inform “clinical” decisions.  What would count as a “good” clinical outcome for an organ transplant?  Survival, survival for 6 or 12 months, or…  To what extent is a person’s quality of life post-transplant relevant? And who gets to decide what a person’s quality of life might be?  (And we can ask the same questions of other clinical interventions too – what counts as success – and who defines it?)  But one cannot really ask the “success” question without also asking at what cost?  Donor livers are very scarce resources – but, of course, all health resources are scarce in some respect and so should be used with care.  (Interestingly though, in one of these stories it is reported that a living donor was available – should that make a difference?)

Anyway, over to you: Discuss…