Each year, hundreds of thousands of individuals worldwide experience acute or chronic liver failure caused by viral hepatitis, degenerative diseases, trauma, drug overdoses and alcohol abuse. The last of these, alcohol abuse, is a major cause of liver disease in America today.
There are many complex, ethical issues related to the allocation of liver Transplants. This is one of the scarcest of medical resources. How can organs be fairly and equitably allocated? Who keeps the list, and what are the criteria?
Some medical centers will not transplant alcoholics because they believe a substantial percentage will return to drinking. Other centers require “abstinence from drinking at least six months before and after surgery” (Knechtle, 1993, 1916-1918), plus enrollment in a counseling program.
Organ transplantation centers try to have criteria that are solely medical, but this is very difficult in practice. If someone is indigent or homeless, the chances that she or he will be able to survive after a transplant are very low. Transplants require long recovery periods, and once recovered a transplant patient must continue to take large dosages of powerful immunosuppressants for the rest of their lives. In addition, most suffer repeated bouts with organ rejection and must be hospitalized and treated each time. Proper nutrition and a daily schedule that allows for rest, shelter, and regular medical care is needed for an individual to be a good candidate for transplant surgery. Thus, the non-medical becomes medical all too easily.
Worries about allocation take two main forms. Some are worried that the criteria for allocation are unfair, because the rich and famous seem to "jump" the waitlist. Others worry that allocating organs to those who have destroyed their own organs through misuse e.g. alcoholics who need liver transplants and/or allowing prisoners to receive donated organs is both an injury to................
