Friday, August 16, 2013

15-year-old on a Death Panel

Anthony Stokes is a fifteen year old kid that has only months to live because of a bad heart.  Normally such a person is on a heart transplant list.  Because of some medical misbehavior on his part (probably his parents fault for neglecting to properly parent him), the young Mr Stokes is sadly tagged as "noncompliant" and will be refused a heart. This is sad.
his hospital refuses to put him on the transplant list. Why? Doctors told the family it was because of Stokes' "history of noncompliance": "They said they don’t have any evidence that he would take his medicine or that he would go to his follow-ups," his mother says)... The hospital says it is "continuing to work with this family and looking at all options regarding this patient's health care." Transplant lists typically have strict guidelines for potential additions, and patients who are considered a serious risk for non-compliance—i.e., those who might refuse or be inconsistent with follow-up care—may be denied space.
The sadness, genuinely, is that he has the heart problem to begin with, not that he is being refused a heart.  The truth is that there are limited amount of these donor hearts and less donated hearts to transplant than there are people that need them.  That means that doctors literally choose who lives and who dies. This choice is, as far as I know, not based on the quality of the human being (usually) but whether or not medical history and/or evidence suggests that the person will take care of his transplanted organ adequately in all medical respects, and not die anyway, therefore wasting the organ that could have been used on someone that would not reject it through bad behavior.

The Gawker author, however, "Max Read", is not very bright.  He insists that the reason the kid will die is not because of a medical reason but because the kid has bad grades.  Apparently someone whose motives I question told him that and Max did not question the motives because he is taking those words as gospel.  To that end the guy has decided to write a sympathetic sob story attempting to cast a Georgia hospital as a hive of villainy for not giving this kid life.
 Stokes is 15. Georgia allows its residents to seal or expunge their juvenile records, enshrining into law the principle that underage "trouble with the law" is not a past indicator of future behavior—certainly not any more than "bad grades" might be. If the government of Georgia is willing to give Stokes a chance at a full and free adult life, why can't Children’s Healthcare of Atlanta?
Essentially Max is putting the sob story as truth above the more likely facts.

Now let's apply actual reason.
Heart transplants are very sensitive surgeries and there are thousands of people on the national transplant list. Everyone who has ever had a family member waiting for a transplant knows that hospitals take this stuff VERY seriously. If you don't take your meds or engage in unhealthy behavior (eating bad foods, drinking, drugs, physical overexertion, etc.). This kid violated their instructions. This is not a sympathy case. Its really sad, but actions have consequences. When you are getting a second chance at life you don't miss your follow-up appointments and you don't violate the doctors order that are giving you that second chance.
I do not want to be an actual jerk about this but there is a cold reality to this whole thing. And don't get me wrong, there is no angle at which this not sad.  I'm just saying the sadness starts with the heart problem.  If Mr Stokes is passed up for a heart, presumably someone's life is saved for that choice.
the history of noncompliance with his meds is the issue here. The post-transplant med and restricted activity regimen is brutal, and past noncompliance is generally a good indicator of future noncompliance. Noncompliance will trash the heart, which means that not only this kid will die, but also the kid who didn't get a heart because it went to him instead.

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