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Community => Science and Technology => Topic started by: Shane for Wax on December 16, 2013, 06:48:24 pm

Title: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 16, 2013, 06:48:24 pm
Quote
Five-month old Maverick Higgs was born with a severe heart defect, and two surgeries later was still in heart failure. He needed a heart transplant, and fast. But after initially saying he was a candidate, the child's New York-Presbyterian doctors decided there was nothing more they could do to help. They said Maverick had six months to live.

The official reason given for denying Maverick the transplant was because he suffered from Coffin-Siris, a rare genetic defect that the doctors said would put him at risk for infection and tumors. They provided Maverick's parents with a study on the defect.

But when Maverick's mother, Autumn, contacted the study's author, she discovered that there was no evidence to support the theory that children with Coffin-Siris had compromised immune systems.

She was confused, but excited. But when she told the doctors, they still refused to go forward with a transplant to save Maverick's life.

And Maverick's mother figured out the most likely reason why was because the genetic defect did have some documented effects — namely developmental disabilities.

This weekend, CNN published a great, in-depth look at organ transplants and the vague, shrouded methods that doctors use to decide who gets a transplant and who doesn't. In the past, physicians were straightforward about denying transplants to disabled patients — "We do not feel that patients with Down syndrome are appropriate candidates for heart-lung transplantations," one doctor explained, denying a child a transplant in 1995.

But now, in an effort to avoid public outrage, some doctors manufacture other excuses.

Maverick's parents applied to four different hospitals, three of which turned her down, citing the Coffin-Siris defect or, in one case, "the big picture."

Read More (http://gawker.com/disabled-patients-say-doctors-are-denying-them-organ-tr-1474370308)

"We do not feel that patients with Down syndrome are appropriate candidates for heart-lung transplantation." You read that right. Doctors are literally playing God and deciding who is worth saving and who isn't based on completely unrelated disorders.
Title: Re: Doctors Versus Disabled Patients
Post by: Sleepy on December 16, 2013, 07:32:16 pm
The number of people on the waiting list and the shortage of organs results in some really nasty moral decisions. When you've got two roughly equal people and one kidney, what's the best way to decide who gets it?
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 16, 2013, 07:50:54 pm
Because Down syndrome has nothing to do with whether you'll reject an organ or not?

If you've got one guy with history of drug abuse and one guy who has Down syndrome I feel like the organ would go to the guy with the history of drug abuse considering all that I've read in regards to this whole situation. And if you know anything about how organ transplants work and what you need to do, drug abusers have to prove they've been clean x amount of time.

I'm not asking for a repeat of the kid with the lung where it was ruled in favor of morality and the poor sick kid trope. I'm asking that we think for a moment why those who are disabled, mentally or otherwise, are turned away time and time again even if they're doing everything else right.
Title: Re: Doctors Versus Disabled Patients
Post by: Sleepy on December 16, 2013, 08:47:35 pm
My post didn't say anything about whether I agree or disagree, just an overall comment on the matter. I can't say for certain who would get the organ in the drug abuser vs. Down's syndrome guy since it depends on a number of things (including the doctor), but it is a particularly sad situation all around.
Title: Re: Doctors Versus Disabled Patients
Post by: The Illusive Man on December 16, 2013, 09:21:54 pm
The number of people on the waiting list and the shortage of organs results in some really nasty moral decisions. When you've got two roughly equal people and one kidney, what's the best way to decide who gets it?
These moral grey areas as they provide a testing ground for professionals. Who determines what is better and why? As a professional you are expected to recognize when your objectivity is compromised then recuse yourself. If you are unable to do so then a third party steps in and throws you out.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 17, 2013, 12:01:04 am
My post didn't say anything about whether I agree or disagree, just an overall comment on the matter. I can't say for certain who would get the organ in the drug abuser vs. Down's syndrome guy since it depends on a number of things (including the doctor), but it is a particularly sad situation all around.

That, we can agree on. It is also why they have 'boards' made just for these kinds of decisions. They decide if you are eligible to get on the transplant list, but you also need a doctor to put your case in front of them. If the doctor personally decides you are unworthy based on something you can't control, that review board won't see your case.
Title: Re: Doctors Versus Disabled Patients
Post by: mellenORL on December 17, 2013, 03:51:29 pm
The desperate need to make organ donation the default by law is overwhelming. I wish someone would really back the organ donation movement with a ton of education adverts.

Targeting the stupidity of not donating for religious reasons is probably a waste of time, since such people believe they are going to be part of the Zombie Apocal- pardon, Resurrection.

Others who fear that they will be allowed to die in the ER if their blood type matches a top-of-the-list transplant patient also have a near impossible level of stupidity to overcome. It is such a bitter situation, that I would even make picture ads of just what disinterred corpses look like, even those perfectly embalmed, after a few years.

I.e., "You and your deceased loved ones will not be a pretty sight. When the deceased are middle aged or younger, often times all of those organs disintegrating 6 feet under could have saved; 2 kidney patients, 1 liver patient, 1 heart patient, offered the chance to see again to 2 blind people, the bone marrow could have been harvested to support many leukemia patients, harvested veins and bones to help trauma and cardiac patients, and skin to help burn victims. The fibrous matrix of many tissues could have also helped numerous people, as the patient's own cells can now be grown onto those matrices for replacement parts that don't cause rejection."
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 17, 2013, 04:02:45 pm
This is why my default reaction to "Would you like to be on the organ donor list?" will always be "yes".

I haven't accomplished much in life, but if in the case of an accidental death I can save people's lives... then I'm okay with that.

The rest of me can be turned into fertilizer.

Though I am upset that people with certain unrelated disabilities are just not even considered for the list.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 17, 2013, 04:04:03 pm
It's why I'm an organ donor first and on the list to be used in the body farm as a second option in case my organs are too bad for a transplant but a good exercise for the body farm.
Title: Re: Doctors Versus Disabled Patients
Post by: Old Viking on December 17, 2013, 08:16:13 pm
If doctors aren't the primary gatekeepers for transplant decisions, who should be?
Title: Re: Doctors Versus Disabled Patients
Post by: Cerim Treascair on December 17, 2013, 10:41:59 pm
It's why I'm an organ donor first and on the list to be used in the body farm as a second option in case my organs are too bad for a transplant but a good exercise for the body farm.

Likewise.  Especially with my being a fatty.  If there's SOMETHING of mine that can be made use of, then break out the scalpel and start slicing, doc!
Title: Re: Doctors Versus Disabled Patients
Post by: kefkaownsall on December 18, 2013, 12:38:48 am
I got it on my license
Title: Re: Doctors Versus Disabled Patients
Post by: Sylvana on December 18, 2013, 04:19:10 am
Though I am upset that people with certain unrelated disabilities are just not even considered for the list.

The thing is, that given the severe shortage of transplant organs when weighing the value of the lives that can be spared, unrelated disabilities are important and should be considered.

If you have two people and say only one organ and one will die before another organ is available, if both patients are healthy in every other way except such disabilities, then the logical choice is to save the person who would potentially get the most out of an extended life.

It would be nice to save everyone, and give everyone replacement organs, but reality is never that pleasant. Shortage of organs can sometimes cause ideal approved candidates to die anyway simply because they ran out of time. When weighing the candidates for an organ, it is important to remember that those counsels are literally choosing who lives and who dies. If done correctly, it is a heavy responsibility and deserves in depth consideration.

If anything we should be truly upset about the corruption in those counsels. Our former minister of health was an alcoholic and had two liver transplants. There were even reports that she was drinking while in hospital. Those livers could easily have saved someone far more deserving, but because of corruption she was given the organs, and she pissed them away by continuing to drink like she used to. This is undoubtedly just one example of many and it is truly sickening.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 18, 2013, 05:06:17 am
Who's got the right to say disabled people get less out of life than neurotypical people?
Title: Re: Doctors Versus Disabled Patients
Post by: Yla on December 18, 2013, 06:33:38 am
Benefit to society would be another argument, if all other things are equal.

I was starting to compose a post here, and then I understood the importance of whether the term should be 'disabled' or 'differently abled'. Makes a world of difference.

I'll come back to this topic later.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 18, 2013, 09:50:17 am
Who's got the right to say disabled people get less out of life than neurotypical people?

Exactly. We already have guidelines to prevent someone actually undeserving of it (as I mentioned, drug addicts cannot be put on the list until they have been clean x amount of time. Which is a lot more logical than saying that someone with Down syndrome is not eligible at all no matter how high functioning or clean they might be).

Would I be undeserving of a kidney transplant because I cannot walk, because I am functionally paralyzed from the waist down? Would I be undeserving because I have depression? The articles I'm reading give me a resounding 'yes'. For things outside of my control. Even though I'm perfectly within the guidelines where everything else is concerned. The doctors are operating under a bias that should not exist where everything else is equal.

Benefit to society would be another argument, if all other things are equal.

I was starting to compose a post here, and then I understood the importance of whether the term should be 'disabled' or 'differently abled'. Makes a world of difference.

I'll come back to this topic later.

How do you objectively decide who has a benefit to society? Stephen Hawking has ALS. Would he be on the eligible list or not? And why would you say so versus someone who has Down syndrome or any other developmental problem?

I'm not trying to be difficult or pick a fight. But it really does scare me that some doctor who doesn't even know me outside of my file could decide whether I'm worthy of a transplant or not based on something that really does not affect whether I will reject the organ or not. Nor would it affect how my recovery would go. Certain things should not affect whether I am eligible or not. Being disabled is one of them.
Title: Re: Doctors Versus Disabled Patients
Post by: Sleepy on December 18, 2013, 10:02:02 am
Certain disabilities shouldn't affect whether you're eligible, for sure. But again, when it comes to choosing between two people, one of the things the boards have to determine is who will get the most out of the organ. Given the slew of medical problems that accompany Down's syndrome, they would probably lean towards the non-disabled person.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 18, 2013, 12:06:17 pm
Unless of course it never gets to the board. Which is part of the whole problem.
Title: Re: Doctors Versus Disabled Patients
Post by: mellenORL on December 18, 2013, 12:16:03 pm
Really, between the wealthy and powerful being able to manipulate the system, the organ black market, and the unspeakable ethics of deciding who lives and dies based on X medical criteria (as no doubt it varies around the world), the only viable solution is universal donation by default.

I think for that reason it should be lobbied for rigorously world wide. As others have pointed out, universal donation would very quickly solve these dilemmas, even with the opt-out being integral to the law changes.

People just don't think about doing organ donation; it's a morbid topic for them. As is thinking about pre-planning for their funerals. That's something that traditionally is thought of as an old person's concern. And nobody thinks about how they could die at any time from an accident. And they just don't get the continuous reminders and education about the topic enough, or I seriously think there would be many more organs available now.
Title: Re: Doctors Versus Disabled Patients
Post by: RavynousHunter on December 18, 2013, 12:51:31 pm
You know, I personally find it odd that deciding what happens when and after you die is an "old person's worry."  It'd be far more reasonable to have such things already planned out before you're quote-unquote "old," so you have one less thing to worry about when you should be enjoying the last years of your life.

To that effect, I already know what I want when I die: take what you can from my body that's useable, try to preserve my brain (with orders to use the data to make a robot me if/when such becomes feasible), closed casket funeral, and cremate me.  Now, all I have to worry about in my final years is a will when I have actual assets to give to people.
Title: Re: Doctors Versus Disabled Patients
Post by: Osama bin Bambi on December 18, 2013, 05:34:11 pm
Really, between the wealthy and powerful being able to manipulate the system, the organ black market, and the unspeakable ethics of deciding who lives and dies based on X medical criteria (as no doubt it varies around the world), the only viable solution is universal donation by default.

I think for that reason it should be lobbied for rigorously world wide. As others have pointed out, universal donation would very quickly solve these dilemmas, even with the opt-out being integral to the law changes.

People just don't think about doing organ donation; it's a morbid topic for them. As is thinking about pre-planning for their funerals. That's something that traditionally is thought of as an old person's concern. And nobody thinks about how they could die at any time from an accident. And they just don't get the continuous reminders and education about the topic enough, or I seriously think there would be many more organs available now.

I might be wrong about this, but organ donation may be frowned upon according to some religions because it could be seen as mutilation of a dead body. Also, there's the issue about respecting the personal wishes of the owner of that body.

I must confess that I am not on the organ donor list. I was asked when I got my driver's permit for the first time, but I said no because I needed more time to think about it. I know this sounds selfish, but I am afraid that, in the aftermath of an accident, I am diagnosed as being in a persistent vegetative state, the doctors will not respect my wish to wait a certain number of time to see if I wake up. Some people who are diagnosed as being in PVSs do wake up, and although it's unlikely, I still don't feel comfortable with it.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 18, 2013, 05:49:44 pm
That is actually one of the most prevalent fears preventing people from signing up. I haven't heard many cases of such a fear playing out, tho.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 18, 2013, 07:21:11 pm
I've heard of all of one case of it happening.  It was a discussion as part of ethics, and the doctor responsible was charged with murder.

As far as religion goes, I know that Zoroastrianism holds that the body should be kept intact because your body affects your spirit somehow.  I don't know how they handle the deal with decomposition, but that's what they believe.

They believe it to the point where the family of a Zoroastrian who put himself on the organ donor list vetoed it after his death.  I'm bothered by this.
Title: Re: Doctors Versus Disabled Patients
Post by: Askold on December 19, 2013, 12:52:33 am
I've heard of all of one case of it happening.  It was a discussion as part of ethics, and the doctor responsible was charged with murder.

As far as religion goes, I know that Zoroastrianism holds that the body should be kept intact because your body affects your spirit somehow.  I don't know how they handle the deal with decomposition, but that's what they believe.

They believe it to the point where the family of a Zoroastrian who put himself on the organ donor list vetoed it after his death.  I'm bothered by this.

Well maybe the fact that the donated organ "keeps on living" after the death of the original owner's body is different than the entire body slowly decomposing or being cremated but at least staying "together" for it.

As for the OP, things like this are a bit iffy because it leads a slippery slope down to what exactly are reasons to not give a new organ to a person. It is simple to justify "your body has low chances of accepting the new organ" or "reasons X, Y and Z are likely to cause your death even if you get this particular organ" but once we get down to "I don't think people with Down syndrome should get new organs because..." Because of what exactly? They don't matter? They aren't as important as "normal" people?

That paths leads to some pretty dark places and I'd rather we'd not go down there, again.
Title: Re: Doctors Versus Disabled Patients
Post by: Sylvana on December 19, 2013, 02:51:36 am
Would I be undeserving of a kidney transplant because I cannot walk, because I am functionally paralyzed from the waist down? Would I be undeserving because I have depression? The articles I'm reading give me a resounding 'yes'. For things outside of my control. Even though I'm perfectly within the guidelines where everything else is concerned. The doctors are operating under a bias that should not exist where everything else is equal.

It is easy to disqualify people like drug addicts, but when you have to choose between two perfectly healthy people (in all regards except for the organ they need) then such simple aspects such as being disabled can and does come into play. Remember, that between two people who are otherwise healthy when determining who gets an organ, you are still consigning the other person to die. You claim bias, but saying that it is unfair and biased for a person with a disability to be given the organ is also unfair as you are also consigning someone else who is healthy to death.

Medicine does not work on some kind of system on political correctness, or justice. It works on a system of triage. Who can be saved, and who has the highest chance of surviving. A person with a disability may be able to surpass a healthy person for an organ on grounds as simple as the healthy person having waited too long and as a result being too weak to have a high chance of survival.

Of course in all these examples I have given I have used just two people needing an organ as the example, but in reality the number of people needing organs is in the hundreds meaning that often the selection is between a group of perfectly healthy and eligible people. People with disabilities, just like people with addiction and other problems dont get close to that group (outside of corruption). After all, how do you decide between two equal perfectly healthy candidates?
Title: Re: Doctors Versus Disabled Patients
Post by: Yla on December 19, 2013, 04:53:57 am
Really, between the wealthy and powerful being able to manipulate the system, the organ black market, and the unspeakable ethics of deciding who lives and dies based on X medical criteria (as no doubt it varies around the world), the only viable solution is universal donation by default.

I think for that reason it should be lobbied for rigorously world wide. As others have pointed out, universal donation would very quickly solve these dilemmas, even with the opt-out being integral to the law changes.

People just don't think about doing organ donation; it's a morbid topic for them. As is thinking about pre-planning for their funerals. That's something that traditionally is thought of as an old person's concern. And nobody thinks about how they could die at any time from an accident. And they just don't get the continuous reminders and education about the topic enough, or I seriously think there would be many more organs available now.

I might be wrong about this, but organ donation may be frowned upon according to some religions because it could be seen as mutilation of a dead body. Also, there's the issue about respecting the personal wishes of the owner of that body.
Universal donation usually means opt-out. You can declare that you don't want to donate.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 19, 2013, 08:37:42 am
Would I be undeserving of a kidney transplant because I cannot walk, because I am functionally paralyzed from the waist down? Would I be undeserving because I have depression? The articles I'm reading give me a resounding 'yes'. For things outside of my control. Even though I'm perfectly within the guidelines where everything else is concerned. The doctors are operating under a bias that should not exist where everything else is equal.

It is easy to disqualify people like drug addicts, but when you have to choose between two perfectly healthy people (in all regards except for the organ they need) then such simple aspects such as being disabled can and does come into play. Remember, that between two people who are otherwise healthy when determining who gets an organ, you are still consigning the other person to die. You claim bias, but saying that it is unfair and biased for a person with a disability to be given the organ is also unfair as you are also consigning someone else who is healthy to death.

Medicine does not work on some kind of system on political correctness, or justice. It works on a system of triage. Who can be saved, and who has the highest chance of surviving. A person with a disability may be able to surpass a healthy person for an organ on grounds as simple as the healthy person having waited too long and as a result being too weak to have a high chance of survival.

Of course in all these examples I have given I have used just two people needing an organ as the example, but in reality the number of people needing organs is in the hundreds meaning that often the selection is between a group of perfectly healthy and eligible people. People with disabilities, just like people with addiction and other problems dont get close to that group (outside of corruption). After all, how do you decide between two equal perfectly healthy candidates?

You make it seem like I am fully unaware of the actual process. I know the process. And I know that the list is gargantuan. But by automatically disqualifying someone based on a disability outside of control, that is wrong. I have a problem with the automatically part, and I'm not sure people are understanding that very key word is my problem with this whole thing.

It's like donating blood and how gay men are automatically disqualified from giving blood based on being gay. There's an element here that does not belong in medicine.
Title: Re: Doctors Versus Disabled Patients
Post by: Yla on December 20, 2013, 06:04:58 am
Ah, I think we (me at least) talked about different points. Reading comprehension ftw. I had assumed this was about giving disabled people lower priority than able-bodied.

But an a priori 100% disqualification for disabled people is not okay at all.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 20, 2013, 06:16:04 am
No worries. I probably could have made things clearer. Apologies.

Yeah, it's the latter. Along with that, an investigation showed they weren't even consistent with how they figured out who was eligible and who wasn't.

And for one case, once it was proved that they weren't immunocompromised, which is why the doctor didn't want to put the child on the organ transplant list, they then scrambled to come up with another reason why they didn't feel like the child was a candidate. While I can understand they might not just lay down all the problems preventing someone getting on the list, it still smells bad to me to give one reason then when that one is proved wrong they mention a different reason.
Title: Re: Doctors Versus Disabled Patients
Post by: Sylvana on December 20, 2013, 08:12:01 am
And for one case, once it was proved that they weren't immunocompromised, which is why the doctor didn't want to put the child on the organ transplant list, they then scrambled to come up with another reason why they didn't feel like the child was a candidate. While I can understand they might not just lay down all the problems preventing someone getting on the list, it still smells bad to me to give one reason then when that one is proved wrong they mention a different reason.

The problem with people with disabilities being declined automatically will only be resolved when the number of doner organs exceeds the number of healthy people needing them. Right now, it is simply a matter of expedience to limit the list that the final decision gets made on.

However, the example you provided and the vast majority of cases is that money, bias and corruption are the primary motivators in any kind of organ recipient selection. If the powers that be want to they will whitewash your problems and you will get your organ, if they want it to go to someone else, they will find a reason to disqualify you or to rank you negatively against their preferred recipient. Like I said earlier it makes me sick that the former minister of health literally destroyed 3 livers with alcohol and as a result prevent two people from receiving a liver they undoubtedly needed.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 20, 2013, 07:06:24 pm
And for one case, once it was proved that they weren't immunocompromised, which is why the doctor didn't want to put the child on the organ transplant list, they then scrambled to come up with another reason why they didn't feel like the child was a candidate. While I can understand they might not just lay down all the problems preventing someone getting on the list, it still smells bad to me to give one reason then when that one is proved wrong they mention a different reason.
The problem with people with disabilities being declined automatically will only be resolved when the number of doner organs exceeds the number of healthy people needing them. Right now, it is simply a matter of expedience to limit the list that the final decision gets made on.

I don't think so.  The problem will be resolved when people stop treating neuro-atypicals like they're lesser beings.

Like Shep has been consistently saying, it's not a case of a disabled person being passed up for someone less disabled, it's that the disabled people aren't even being considered or factored at all.  They are effectively non-existent in the eyes of these doctors, and that needs to be addressed post-haste, not when we "have enough organs to go around".
Title: Re: Doctors Versus Disabled Patients
Post by: mellenORL on December 21, 2013, 02:37:43 pm
Strongly agree, Magus. When you extrapolate the practice just one half a degree, it is clearly a de facto death sentence for disabled transplant candidates, and I think legally it is unconstitutional via several clauses, including the 14th, and the ADA.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 24, 2013, 04:41:13 pm
And for one case, once it was proved that they weren't immunocompromised, which is why the doctor didn't want to put the child on the organ transplant list, they then scrambled to come up with another reason why they didn't feel like the child was a candidate. While I can understand they might not just lay down all the problems preventing someone getting on the list, it still smells bad to me to give one reason then when that one is proved wrong they mention a different reason.
The problem with people with disabilities being declined automatically will only be resolved when the number of doner organs exceeds the number of healthy people needing them. Right now, it is simply a matter of expedience to limit the list that the final decision gets made on.

I don't think so.  The problem will be resolved when people stop treating neuro-atypicals like they're lesser beings.

Like Shep has been consistently saying, it's not a case of a disabled person being passed up for someone less disabled, it's that the disabled people aren't even being considered or factored at all.  They are effectively non-existent in the eyes of these doctors, and that needs to be addressed post-haste, not when we "have enough organs to go around".

Especially when that won't be the case for a long, long time. Until we've managed to harness the technology that is still in its infancy (such as 3D printed organs and such).

What needs to be done is having things like this nipped in the bud now before it ends up something ridiculous like 'well, we'd go and grow this organ for you buuuut you're chronically depressed with Asperger's so maybe we should put our effort behind growing the organ for someone else.'.
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on December 24, 2013, 08:42:21 pm
Strongly agree, Magus. When you extrapolate the practice just one half a degree, it is clearly a de facto death sentence for disabled transplant candidates, and I think legally it is unconstitutional via several clauses, including the 14th, and the ADA.

That's the second time you've said 14th amendment, and quite frankly, I'm here to inform you it doesn't mean what you think it means...

Other laws, you could make that argument, but I understand the practice. This is what is called an "ethical dilemma" and it's called that because there is no right answers. Someone will die from this (be it a disabled or an enabled patient) so, I'll sit that debate out and leave it to the medical profession. They're in a better place to make this value judgment than I.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 24, 2013, 09:47:53 pm
The issue isn't over whether or not a disabled or enabled patient deserves the organ more.  The issue is over the fact that the disabled patient isn't even being considered at all.

The ethical dilemma isn't even being reached because it's not being allowed to happen in the first place.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 24, 2013, 10:06:05 pm
I'm really not sure how many times I need to repeat that, Zach. Which thank you for understanding my point. I'm not concerned about the 'more' I'm concerned about the 'not at all'. (Technically both but my entire argument has hinged on the 'not at all' that worries me about the state of healthcare and my chances if I ever need more than a blood transfusion).
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on December 24, 2013, 11:15:05 pm
The issue isn't over whether or not a disabled or enabled patient deserves the organ more.  The issue is over the fact that the disabled patient isn't even being considered at all.

The ethical dilemma isn't even being reached because it's not being allowed to happen in the first place.

Again, I'm sitting it out, but it is being reached because the medical profession is saying "we have this many organs and this many more patients. We'll give these organs to those we feel will have the best quality of life (the enabled patients) over those that won't (disabled patients)." I only say this to say, the moral dilemma is being reached. But again, I'm sitting this out because like that one thread way back in flame & burn about the trans inmate getting SRS, it's a moral dilemma and there are no right answers. People WILL die and people WILL live no matter which course you opt for.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 24, 2013, 11:30:43 pm
Well, since you said that you're going to sit this one out, I'll respect your wishes.

To other people on the forum who are still unconvinced, here's a hypothetical scenario.  A trans* person is kept off of the waiting list simply because they are trans*.  A cisman is admitted to the list with no argument whatsoever.  Does that sound like a simple case of an ethical dilemma?
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on December 25, 2013, 11:22:48 am
Well, since you said that you're going to sit this one out, I'll respect your wishes.

To other people on the forum who are still unconvinced, here's a hypothetical scenario.  A trans* person is kept off of the waiting list simply because they are trans*.  A cisman is admitted to the list with no argument whatsoever.  Does that sound like a simple case of an ethical dilemma?

Respect my wishes you say... and then you make a transparent post hoping to flamebait me back in...

I'm still sitting this one out, I'm just calling you out on such an obvious post (because no one else will). So Merry Christmas.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 25, 2013, 04:22:28 pm
I'm sorry for any offense, but my post is legitimately just aimed at other people reading this topic.  In some places, transgenderism is still considered a mental illness, so what I described could be happening right now.  Hence why it made a good example.

You know what it's like to have people continuously miss your point, I'm just trying to clarify it and prevent it from happening again.
Title: Re: Doctors Versus Disabled Patients
Post by: Sylvana on December 30, 2013, 09:25:04 am
Well, since you said that you're going to sit this one out, I'll respect your wishes.

To other people on the forum who are still unconvinced, here's a hypothetical scenario.  A trans* person is kept off of the waiting list simply because they are trans*.  A cisman is admitted to the list with no argument whatsoever.  Does that sound like a simple case of an ethical dilemma?

Yeap, it is still a simple medical situation.
Given the rarity of organs, a trans-person wouldn't even begin to be considered. In the great grading of people and where they lie in getting organs, trans-people would rate below people with mental disorders, they are higher risk, and the external hormone use places an extra burden on most organs.

Just like how people with mental disorders are not considered, trans-people are also not considered because there is always another perfectly healthy individual who needs an organ.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on December 30, 2013, 01:00:14 pm
Yay neurotypical/cisgender privilege then.  Everything is right with the world. </sarcasm>
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 30, 2013, 01:12:05 pm
The fact that I can still taste bile should tell you how I feel about this whole thing. I honestly don't know how someone can be perfectly okay with something like this simply because it's an 'unfortunate moral dilemma'. But then, I'm biased considering the fact that I am now terrified I might need a kidney transplant in the future and be denied simply for being who I am and having problems I can't control.
Title: Re: Doctors Versus Disabled Patients
Post by: mellenORL on December 30, 2013, 02:00:56 pm
Shep, do you have a blood relative known to you who might donate a kidney in that case?
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on December 30, 2013, 06:05:18 pm
My dad and I are a blood match (we're both A+) and he has said before he would but it depends on multiple factors. Since I'm adopted it would wind up being either my dad (who just happens to share my blood type) or someone on the registry. Since transplant doesn't go entirely by blood match (you also have to match tissue type and other things) there are no guarantees that dad would be a match (it doesn't have to be 100%. There is room for 'error' but you have to be at least 80% I think?)

Beyond dad? No. Unless I end up tracking down my biological family which could also be a possibility, depending.

Hence my worries. Because I actually have had to look into such things based on my anomalies. I had to have a blood transfusion when I was little and that put me on the road of being prepared for a possible organ transplant such as kidney since I have some of the most problems with them.

EDIT- I just remembered that dad had hepatitis B which could disqualify him from being a donor. I know he's not allowed to donate blood anymore so I suspect that that means he can't donate organs either. Well... fuck.
Title: Re: Doctors Versus Disabled Patients
Post by: Yla on January 01, 2014, 10:44:03 am
Yay neurotypical/cisgender privilege then.  Everything is right with the world. </sarcasm>
Yay for ignoring the reasons Sylvana cited and behaving like it's all about cissexism.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 01, 2014, 06:56:27 pm
Yay neurotypical/cisgender privilege then.  Everything is right with the world. </sarcasm>
Yay for ignoring the reasons Sylvana cited and behaving like it's all about cissexism.

Her reasons were effectively "neurotypical cisgendered people get more out of life than neuro-atypical and transgendered people do, so the doctors deciding to completely exclude the latter in favor of the former are doing the right thing".

I don't think I'm the one ignoring reasons here.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on January 01, 2014, 08:27:40 pm
Also if the 'extra hormone use' is a perfectly legitimate reason to deny an organ transplant then I guess those on birth control should also be excluded. As well as those who have to have hormones for whatever other reason that is legitimate medical need. Even if we ignore the fact not every transperson wants or is on hormones.
Title: Re: Doctors Versus Disabled Patients
Post by: Sylvana on January 02, 2014, 02:30:09 am
Her reasons were effectively "neurotypical cisgendered people get more out of life than neuro-atypical and transgendered people do, so the doctors deciding to completely exclude the latter in favor of the former are doing the right thing".

Very well, lets turn this around then.
Let us say you get your way. Everyone is allowed to be eligible to receive organ donations, and that it somehow does not create a massive administrative overhead.

You have one organ and two people who need it.
One had no significant medical history, the other is diagnosed with bipolar disorder, but it is in remission and being treated. Both patients have the same gender and are the same blood type, tissue type, race, economic standing etc.

Who gets the organ, and why?
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 02, 2014, 03:45:38 am
I don't know who should get it.  That's not for me to say.

What is for me to say is that both should be considered.  Anything else is blatant discrimination against neuro-atypicals.

In short, the scenario you presented should be happening.  That's all I've argued and all I will argue.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on January 02, 2014, 04:05:14 am
It's a whole quality of life issue. Instant disqualifications on the basis of discrimination, rather than clear problems such as drug abuse, should not be happening.
Title: Re: Doctors Versus Disabled Patients
Post by: m52nickerson on January 02, 2014, 08:43:13 pm
I don't know who should get it.  That's not for me to say.

What is for me to say is that both should be considered.  Anything else is blatant discrimination against neuro-atypicals.

In short, the scenario you presented should be happening.  That's all I've argued and all I will argue.

If both are considered but the one free from the neurological issues always loses what than is the point? 
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 02, 2014, 08:51:45 pm
I don't know who should get it.  That's not for me to say.

What is for me to say is that both should be considered.  Anything else is blatant discrimination against neuro-atypicals.

In short, the scenario you presented should be happening.  That's all I've argued and all I will argue.

If both are considered but the one free from the neurological issues always loses what than is the point? 

Did I say that the one free from neurological issues should always lose?

*re-reads post* Nope.

In fact, I explicitly said I don't know who should "lose".  Just that both should be allowed to "compete", instead of one always being excluded.

Shoving words down people's throats is a most dishonest tactic.
Title: Re: Doctors Versus Disabled Patients
Post by: m52nickerson on January 02, 2014, 09:09:01 pm
I don't know who should get it.  That's not for me to say.

What is for me to say is that both should be considered.  Anything else is blatant discrimination against neuro-atypicals.

In short, the scenario you presented should be happening.  That's all I've argued and all I will argue.

If both are considered but the one free from the neurological issues always loses what than is the point? 

Did I say that the one free from neurological issues should always lose?

*re-reads post* Nope.

In fact, I explicitly said I don't know who should "lose".  Just that both should be allowed to "compete", instead of one always being excluded.

Shoving words down people's throats is a most dishonest tactic.

Calm down, I didn't mean to make it seem as if you said the one with neurological issues would lose.  However given everything else being equal I would expect them to.  You are not making the call but the doctors who are are not going to throw dice or flip coins.  Neurological issues are going to be seen as a negative and in the hypothetical we are talking about that is going to be the deciding factor.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 02, 2014, 10:39:40 pm
Calm down, I didn't mean to make it seem as if you said the one with neurological issues would lose.

Uh... you said the one free from neurological issues.  Not the one with neurological issues.  That changes a few things.

That being said, if they always lose, that is still pretty much discrimination.  But it's less discriminating than simply being excluded from the list at all, because in the event that TWO organs are available and two people need it, then both will get it.  Whereas before, the organ just gets put in storage and the person with the mental illness wouldn't be able to get it at all due to not being on the list.  An important thing, which I don't think Sylvana took into account.
Title: Re: Doctors Versus Disabled Patients
Post by: Sigmaleph on January 02, 2014, 11:00:21 pm
I don't know who should get it.  That's not for me to say.

What is for me to say is that both should be considered.  Anything else is blatant discrimination against neuro-atypicals.

In short, the scenario you presented should be happening.  That's all I've argued and all I will argue.

If both are considered but the one free from the neurological issues always loses what than is the point? 

The point is that, in the general case, it won't be "two people identical in every relevant aspect except for neurological issues". It would be one factor among many.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on January 03, 2014, 12:26:08 am
I have said it once I've said it a billion times:

I am not asking for the neuroatypical to automatically win. I'm asking for them to not automatically lose. A single doctor should not play gatekeeper for getting onto the organ registry. That is what I have the problem with.

Here's a scenario:

You are diagnosed with liver failure at the same time as being diagnosed as having Asperger's (unlikely but for the sake of argument). Suddenly, your doctor no longer is saying 'we'll get you on the registry don't you worry!'. Instead, he suddenly turns around and says 'I'm sorry, but you are not eligible'. And then it turns out that he is actually highly ableist against neuroatypicals. What happens then? Should you just accept that your life is now worth less because you have Asperger's? Or, should you instead fight to have the same rights as someone without Asperger's? Should you instead demand his opinion, his singular opinion, shouldn't keep you off the registry?
Title: Re: Doctors Versus Disabled Patients
Post by: Sylvana on January 03, 2014, 02:48:09 am
That being said, if they always lose, that is still pretty much discrimination.  But it's less discriminating than simply being excluded from the list at all, because in the event that TWO organs are available and two people need it, then both will get it.  Whereas before, the organ just gets put in storage and the person with the mental illness wouldn't be able to get it at all due to not being on the list.  An important thing, which I don't think Sylvana took into account.

I agree, in a world where spare organs are plentiful, preventing someone with mental disorders from being eligible is discrimination. However in the real world there are always far more people needing organs than there are organs available.
A more accurate example of how reality is would be: You have a single replacement organ and 10 people who need the organ. They are all equal in every way except that 1 has a neurological disorder. Who gets the organ?

The basic rule at play here is triage.
The person with the highest chance of survival is given the limited medical resources needed. Unfortunately in the grand scheme of things, having a mental disorder places you lower on the triage list. People with neurological disorders will be placed behind those people who are effectively healthier, behind all the healthy people who will also never get the organs. Until replacement organs are available in sufficient quantities to finally treat all the healthy people on the lists, there will be automatic exclusions.

In a perfect world automatic exclusions wouldn't exist and there wouldn't be discrimination, but one must remember that the medical world is not politically correct nor can it afford to be.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 03, 2014, 04:11:48 am
Pardon, are you saying that people with Asperger's and Bipolar Disorder have a lower chance of survival?

'Cause I don't think they do.

You can harp on about "political correctness" all you want, but it's about anti-discrimination.  Would you support it if a black person was put behind white people because "black people are more likely to be murdered"?
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on January 03, 2014, 04:20:16 am
I'm really not sure how a neurological disorder is going to affect one's survival rate unless they are on suicide watch.

And as mentioned, we're already on the way to having enough organs for everyone. But the mindset that those who have a mental disorder are less worthy needs to start going away now.
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on January 03, 2014, 06:04:36 am
Pardon, are you saying that people with Asperger's and Bipolar Disorder have a lower chance of survival?

'Cause I don't think they do.

You can harp on about "political correctness" all you want, but it's about anti-discrimination.  Would you support it if a black person was put behind white people because "black people are more likely to be murdered"?

Zachski, I'm going to put it in the most basic terms. There has been one fact critical to this debate that has been ignored, organs are limited, people will die.

I repeat. No matter what decisions you make, I make, doctors make, or society makes, people will die. This is the unpleasant fact here. This is not My Little Ponies. Princess Celestia will not come out of the clouds at the last minute and create a secondary organ. If A lives, B dies; if B lives, A dies.

So, how do answer this question? How do we determine which lives are worthy of living relative to those who unfortunately are not worthy? As Nick said, "doctors are not going to flip coins or throw dice over such an important decision." The answer, we literally put a value on life. We look at this in the most Un-PC manner. It's not fair, but neither is life nor the situation. We factor in certain conditions, come up with a value of that person's life, and we come to the conclusion on who lives and who dies. Unfortunately, we've gotten on a bit of a tangent. The OP discussed Coffin-Siris syndrome and Down's Syndrome; two conditions which (again, un-PC) objectively create a lower value and quality of life. They are less likely to be the heads of households, less likely to be important or contributing people in society (in purely economical terms), and less likely to enjoy the same quality of life as most society. Call this ableist all you want, but such is the unpleasant reality of triage.

Then, you got off on the tangent of transsexuality (largely I feel as a political point, a "gotcha Queen"). But you know, I will say it, in this instance, we have to look at the issue on paper. Again, it's not fair, but neither is life, nor the situation. If life were fair, I'd have a vagina. If factors stemming from my transsexuality (lack of dependents, weaker organs via HRT, etc) determines I should die, so be it. Like I said, people will die and this isn't pretty. Now, of course I would understand someone being a hypocrite and fighting tooth and nail when it's them, I would. But on paper, some people have to die and I could very well be that person.

And the whole reason is, as Sylvana said, triage. The purpose is to determine who has the best chance of living a productive live (productive in both personal and societal senses). Like, pretend we have two patients. Both need livers, we have one liver. Patient A is 25, has a host of health problems, in and out of the hospital, and with the liver, likely wouldn't live past 40. Patient A has no job, no children, and no body who depends on her. She lives largely off of medicaid and low income assistance. Patient B is 40, a widower with three children who depend on him. He makes enough of an income to give them a good life. If we ignore these health factors (or if we include them, ergo a de facto discrimination) and go with patient A, we have condemned 3 kids to a life of poverty and in a few years will have 2 dead people instead of 1.* To choose B solely because of A's condition would be ableism, but it would also be the best decision to make for society. Ultimately, the goal of all institutions should be utilitarian.

And this is the whole cause of the debate, the intentional misrepresentation of triage. It's not a list of qualifiers and disqualifiers, but a hierarchy of who is most deserving all the way down to the least deserving. Unfortunately, we perpetually have a lower amount of organs than patients who need them. Thus, the criteria which put one at the bottom of the list is a de facto disqualifier (down's syndrome for example, they go to the bottom of the list, we have limited organs, they don't get one, they die). If science were to develop advanced 3-D organ printing tomorrow or find a cache of well-preserved organs, those with coffin siris or down's syndrome would not be disqualified from transplants, they would get them. Therefore, the issue is not "you have down's syndrome no organs" but "we have limited organs, you have this condition, we're sorry." So, what we are arguing is not "qualifiers and disqualifiers," but the hierarchy of needs the medical profession uses. It just appears as a list of qualifiers and disqualifiers because perennially we have fewer organs than patients.

*while we can't know for certain, hey, patient B may be hit by a bus tomorrow, again, we look at this on paper.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on January 03, 2014, 07:15:12 am
Re- "ignoring"

(https://24.media.tumblr.com/d6af13a96ffe42d116e73fd751f24e73/tumblr_murfggQfl11qdl4w6o1_500.gif)

Except not. Also that jab about MLP was unnecessary but whatever.

You keep using the word triage. I don't think it means what you think it means. Triage isn't performed on paper unless you're in the classroom. I went to the ER throwing up with a high blood pressure and they didn't decide to take me back quickly based on what they saw ~on paper~. They didn't see me as being depressed with ADHD while they were doing their triage. Because it wasn't pertinent.

But whichever. Believe as you will, I guess.
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on January 03, 2014, 10:18:09 am
1. Snarky GIFs do not make a point. I'm kind of sick of seeing the same posters use them ad nauseam.
2. The MLP reference was necessary to say, "the world isn't sunshine and unicorn farts." What part of "PEOPLE WILL DIE," is so hard to understand? There isn't going to be a "happy ending" only a "less worse" one.
3. From Wikipedia,

Quote
Triage is the process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately... Because treatment is intentionally delayed or withheld from patients, advanced triage has ethical implications.

4. Do you know what it means? There is a bit of difference between "going to the hospital throwing up" and "I need one of a limited few kidneys." They could realistically treat everyone throwing up (unless it were life threatening and they had limited vaccines) your conjecture proves nothing.
Title: Re: Doctors Versus Disabled Patients
Post by: Art Vandelay on January 03, 2014, 11:31:13 am
1. Snarky GIFs do not make a point. I'm kind of sick of seeing the same posters use them ad nauseam.
Slightly off topic, but fucking thank you. I thought I was the only one who was fed up with it.
Title: Re: Doctors Versus Disabled Patients
Post by: Ghoti on January 03, 2014, 11:45:34 am
{rant}
{more rant}
*with the intention of lightening the mood somewhat* Jerry, Jerry, Jerry...?
Title: Re: Doctors Versus Disabled Patients
Post by: wrightway on January 03, 2014, 12:27:56 pm
Okay, I'm curious. Do doctors seriously have a quanitfiable list of traits worth X number of points to determine who does and does not get an organ? Or are you guys talking strictly in the hypothetical?
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 03, 2014, 04:38:08 pm
I thought you were going to sit out of this conversation, Queen?
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on January 03, 2014, 06:24:06 pm
I thought you were going to sit out of this conversation, Queen?

I tried to sit it out, I really did, but this conversation just looked like too much fun for me to avoid.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 03, 2014, 06:33:26 pm
I thought you were going to sit out of this conversation, Queen?

I tried to sit it out, I really did, but this conversation just looked like too much fun for me to avoid.

Alright, then I have a simple question for you.

Do you think a doctor should be allowed to exclude black people from the list?
Title: Re: Doctors Versus Disabled Patients
Post by: Ghoti on January 03, 2014, 07:06:18 pm
Oh boy, here we go. *prepares popcorn, hotdogs, marshmallows, etc*
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 03, 2014, 07:09:00 pm
Oooh, can I have some?
Title: Re: Doctors Versus Disabled Patients
Post by: Ghoti on January 03, 2014, 07:17:06 pm
Oooh, can I have some?
Sure, what would you like? Hot dog? S'more? Campfire baked potato? The popcorn will be ready in a minute.
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on January 03, 2014, 07:17:27 pm
No treats for anyone, I'm here to shit on this parade.

I thought you were going to sit out of this conversation, Queen?

I tried to sit it out, I really did, but this conversation just looked like too much fun for me to avoid.

Alright, then I have a simple question for you.

Do you think a doctor should be allowed to exclude black people from the list?

Of course not, there is nothing about being black that affects quality of one's life. Now, other factors stemming from racism (lower education, less resources, less education, more likely to be harassed by cops) should. Again, this isn't humane or ideal, but neither is the situation. Unfortunately, this would bias the system against blacks for the aforementioned reasons. Thing is, we can't qualify how much these things matter (example: If this black man were given the resources and respect of this white man, the former would life and not the latter). Just like how I said that transsexual traits (unlikely to have biological kids and possible organ damage from HRT) should factor in, even though trans-asterisk-ness should not (because, again, we can't qualify such things.) But instead of having affirmative action for minorities in organ trans*plants, why not focus our energies on society to change these problems so things like skin color and homosexuality won't correlate with being denied the organ. Shit, lord knows I'd rather society just be cool about me being trans-asterisk than be shitty to me and give me a needed organ.

But that's the joy, the OP and the article mentioned two very serious problems which would prima facie affect one's quality of life; coffin siris syndrome and down's syndrome. You've continued to strawman the issue from those serious problems into miniscule things like race and trans-asterisk-sexuality because you refuse to see this as a triage hierarchy issue and instead view it as "that mean doctor won't do this solely because of X characteristic." The difference being the former is an example of who lives and who dies. The latter would be discrimination, but that isn't happening. You're so sure it is, and you're confusing correlation with causation. If we had the organs, they would receive them. However, the status quo is a de facto denial because such problems put those people near the bottom of the list. Do you really think if we had 100 patients (50 with down syndrome, 50 without) and 51 organs, a doctor would be so callous as to say "well, throw that liver in the compost pile, we have no use for it"?

But quid pro quo, you ask me a question, now I get to ask you one. Remember Sylvana's question on page four about the two identical patients, but one was bi-polar, albeit in remission? I would really like to see your answer to that question. Or better, two patients, one liver. Patient A has down's syndrome, is 30, lives off welfare, has no family, no job. Patient B is the same age, has two kids who depend on her. She is the breadwinner for her family making a sizable income with a top accounting firm in the country. Neither have criminal records nor histories of drug abuse. Who lives, who dies Dr. Silveresti? Why?
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 03, 2014, 07:25:43 pm
And I will tell you the same thing I told Sylvana.

I'm not qualified to make that decision.  However, both should have a chance at it.  That is all I have argued and all I will ever argue.

As it stands now, neuro-atypicals have zero chance because they are not on the list at all.

Let me emphasize something before you try shoving arguments down my throat again:

If it was a simple case of them being lower priority on the list, that would be understandable.  It's not fair, but then you are right about one thing, life isn't fair and doctors have to make difficult decisions.

But they aren't lower priority on the list.  They aren't even on the list.  THAT is the part I and Shepard have an issue with.  This IS discrimination, whether you like it or not.


There are no strawmen involved here.  Just plain and simple fact.

So, I suppose to answer your question, BOTH should be on the list, but all factors considered, Patient B should get the liver.  But then if another liver comes into play, then Patient A should get a liver, too, because Patient A should be on the list.
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on January 03, 2014, 08:08:10 pm
Would anything change if I told you the person in the OP, the one who needed the heart and lung transplants in 1995 (http://articles.latimes.com/1997-05-25/news/mn-62466_1_lung-transplant), got both?

Would anything change if I told you she died 16 months later?

End result, we have two dead bodies instead of one.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 03, 2014, 10:13:26 pm
Would it change anything if I told you that her Down's Syndrome had no correlation with her death, and that even neurotypical cisgendered people sometimes die after an organ transplant that should've worked?

End result, even if the organ had gone to someone else, we still could've ended up with two dead bodies instead of one.
Title: Re: Doctors Versus Disabled Patients
Post by: Shane for Wax on January 04, 2014, 11:19:37 am
1. Snarky GIFs do not make a point. I'm kind of sick of seeing the same posters use them ad nauseam.
2. The MLP reference was necessary to say, "the world isn't sunshine and unicorn farts." What part of "PEOPLE WILL DIE," is so hard to understand? There isn't going to be a "happy ending" only a "less worse" one.
3. From Wikipedia,

Quote
Triage is the process of determining the priority of patients' treatments based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately... Because treatment is intentionally delayed or withheld from patients, advanced triage has ethical implications.

4. Do you know what it means? There is a bit of difference between "going to the hospital throwing up" and "I need one of a limited few kidneys." They could realistically treat everyone throwing up (unless it were life threatening and they had limited vaccines) your conjecture proves nothing.

Awwww poor you. Would you have preferred I used it in text instead? I could have. Here, instead of using the gif I'll do this: "An honest asshole, how nice." There we go.

Also your little 'definition' doesn't prove me wrong. Because they have a limited number of beda in the ER and they base who gets what based on severity. So don't give me that shit about how it's different from organs. It's still a limited resource that you have to decide who gets what with.

And again, I have a gif that would be quicker but I'll just do this: "Don't even answer. It doesn't matter. I'm leaving."

(click to show/hide)
Title: Re: Doctors Versus Disabled Patients
Post by: QueenofHearts on January 04, 2014, 03:50:37 pm
Would it change anything if I told you that her Down's Syndrome had no correlation with her death, and that even neurotypical cisgendered people sometimes die after an organ transplant that should've worked?

End result, even if the organ had gone to someone else, we still could've ended up with two dead bodies instead of one.

But would it change ANYTHING at all for you to admit that she did get her transplant and therefore was not precluded as you've been saying? Even more damning, how about how they performed two transplants on her and not one? This proves everything I've been saying, that disabled people are NOT being precluded, they're just on a lower triage scale with a limited number of organs. A de facto exclusion, but not being excluded as you've attempted to portray.

As to her dying, I knew you'd look the story up and make that point. So, now that we know you are qualified to make medical judgments, why won't you answer my question on page 5?

And Shane, a limited number of beds is quite a stretch. Even including and accepting such, that does not mean that some people in your situation would live and die, as must be the case with this topic. And chill out, I've been civil with you in this debate, and if not civil, certainly MORE civil. So, yeah.

ETA: and as to the claim that I'm an "honest asshole" stop. I admit, this whole fucking process is inhumane, but the ADA has their procedure and it's their best attempt to make lemonade out of lemons. I don't want anyone to die, but in situations like this, people will die and there is nothing you, the doctors, or anyone can do about it. The worst thing I think we can do is to give these organs to people who don't have as strong a chance of survival, because then we have two dead instead of one. Sorry if situations demand such callousness.
Title: Re: Doctors Versus Disabled Patients
Post by: Witchyjoshy on January 04, 2014, 06:44:31 pm
Would it change anything if I told you that her Down's Syndrome had no correlation with her death, and that even neurotypical cisgendered people sometimes die after an organ transplant that should've worked?

End result, even if the organ had gone to someone else, we still could've ended up with two dead bodies instead of one.

But would it change ANYTHING at all for you to admit that she did get her transplant and therefore was not precluded as you've been saying?

Would it change ANYTHING at all that the fact that this still happens to other people based off of irrelevant disorders?

Seriously, you seem to believe that CDR Shepard and I are upset about this one person.  We're upset about all the OTHER PEOPLE this is happening to, as well.

Maybe if you made the effort to understand your opponent's arguments instead of being caught up in your own, we could get somewhere.

Also, I did answer your question.  Go back and read it again.
Title: Re: Doctors Versus Disabled Patients
Post by: m52nickerson on January 05, 2014, 08:48:22 am

Would it change ANYTHING at all that the fact that this still happens to other people based off of irrelevant disorders?

Seriously, you seem to believe that CDR Shepard and I are upset about this one person.  We're upset about all the OTHER PEOPLE this is happening to, as well.

Maybe if you made the effort to understand your opponent's arguments instead of being caught up in your own, we could get somewhere.

Also, I did answer your question.  Go back and read it again.

Pretty sure everyone understand what you and Shepard are saying.  What the both of you seem not to understand is that nothing is irrelevant when it comes to trying to decide who gets organs and who does not.  That decision very much means some people will live and some will die.  So these boards look at every statistic and possible complication they can and make the best decision they can.  It's not PC and it is not fair, but it is a situation in which nothing is fair.