10.1 Past Offenses

When hospitals weigh the pros and cons of transplantation, they will ultimately choose on a single justification for rejection. Refusing a liver transplant to a patient who refuses to cut down on alcohol use is grounds for denial. Similarly, a patient undergoing a lung transplant cannot continue smoking. More esoteric explanations, such “noncompliance,” will be offered on occasion, nevertheless.

Concern that the patient will not take the necessary measures to guarantee a healthy recovery following the transplant is just one of many possible interpretations in the context of organ transplantation. In 2013, a life-saving heart transplant was denied to 15-year-old Anthony Stokes due to his noncompliance. In official terms, it indicated that the youth had a record of failing classes and serving time in juvenile prison. His criminal record was the main reason the hospital turned down his life-saving request. At age 15.

The hospital miraculously reevaluated its stance and reversed it as the news spread. The operation and transplant were approved for the kid, who had been assigned a six-month survival window. Two years after he had escaped from the police, Stokes tragically perished in a car crash, adding one further twist to the tale.

9. Records of Vaccination

There have been more twists and turns than a Pogo stick in the COVID-19 pandemic, but one thing that has emerged from it is the gulf between vaccinated and unvaccinated people. Those who choose not to get vaccinated have discovered that the world is increasingly turning its back on them. People without vaccination documentation were denied entry to restaurants, theaters, and borders. It would make sense that a lung transplant would be off the table if vaccinations are required to dine indoors at restaurants.

Hospitals have started to take severe measures against the unvaccinated as more than half of the globe is now vaccinated, including approximately 64 percent of Americans. In particular, they stood out when they rejected 31-year-old DJ Ferguson’s request for a heart transplant, citing his lack of vaccination as one reason.

When selecting candidates for the restricted number of organ transplants, the hospital reportedly considers factors such as vaccination status and lifestyle choices in order to provide the highest possible chance of survival to those who get them. Put simply, they will not proceed with the treatment if you are unwilling to receive a vaccine that protects you from a disease that is likely to be fatal to you after a transplant. The patient views the vaccine as crucial because their immune system is practically nonexistent after a transplant.

8. A Game of Numbers

Approximately 40% of farm-grown produce is thrown out before it reaches consumers, just because it doesn’t look good. There is a tremendous loss of food when imperfect product is not sold since it is not marketable. After all, who would want a flawed apple? Quite a few, actually, but that’s unimportant. It also turns out that human organs are subject to the same mentality.

A modification to government criteria in 2007 started turning away imperfect organs, by whatever criterion one uses to determine such a classification. The bottom line was at the heart of this matter. Surgery on an imperfect organ, like surgery on a severely sick recipient, has a higher risk. A lower success rate is associated with more dangerous surgeries. The federal government will cut off funding to a hospital if its rankings drop due to an excessive number of botched surgery. So, they limit themselves to what they call “sure thing” surgeries and execute fewer transplants overall to maintain their good scores.

This viewpoint contradicts the original intent of organ transplants and the principle that the sickest patients should have priority when requesting transplants. Standards were adjusted to permit hospitals to experience more surgical failures without incurring financial losses following the release of a paper describing this, but it appears that this metric is still used to determine financing.

7. People Turned Down Because They Were Too Poor

Envision yourself informed that a heart transplant is your only hope for survival due to heart failure. There are 100,000 patients on the transplant waiting list, and we already know that there aren’t enough organs to go around. Assuming you meet all the requirements and are in generally good condition, though, you should be towards the top of the list. Now picture yourself learning that a heart transplant typically costs more than $1.3 million.

As strange as it seems, you can really be denied a potentially life-saving operation just because you cannot pay it. A heart transplant was not made available to Hedda Martin due to her inability to pay for it. The medical center advised that she launch a campaign to collect $10,000 or more.

Before a possible transplant may be advanced, patients are often asked to provide proof of financial stability. Even a kidney can cost as much as $400,000, with a heart being the most costly. On top of that, there are anti-rejection medications that you must take for the whole duration of your anticipated post-operative survival, which can cost up to $2,500 per month.

Many organ recipients launch GoFundMe pages, but if the funds don’t come in, the organs won’t either.

6. The Danger of Disability

Obviously, the information that medical experts use to choose who gets an organ transplant—and, by extension, who lives and who dies—is not available to the general public. However, we are able to make some assumptions that are consistent with logic. Which, subjectively speaking, ought to be correct. It appears to be an obvious necessity when we learn that an infant requires a heart transplant. Naturally, a newborn takes precedence. There’s a new little one.

A heart transplant was rejected to a 5-month-old infant who was born with a cardiac abnormality in 2013. Heart failure has set in after two unsuccessful procedures. His life was about to end. His medical history made him vulnerable to infections and malignancies, according to the doctors. However, his mother was unable to locate any online references to that fact while researching his condition. She received confirmation from a doctor.

What she did know was that her son’s condition was associated with a high prevalence of severe problems in later life, which she believed to be the underlying cause. A kidney transplant was necessary for a three-year-old child who had experienced the same incident. We will discuss how intellectual problems prevent people from being considered for organ transplants later on, but this was a preventative measure taken against a baby who hadn’t even had a chance to mature yet.

5. Cognitive Impairments

What constitutes ineligibility for a transplant has been one of the most contentious ethical issues in the medical field. Intellectual disability is the most hotly contested topic. Transplanting an organ to a person who has intellectual handicap is, in the eyes of some, a complete waste of life.

Naturally, people start talking about it, the media covers it, and maybe even some people sign petitions. However, very nothing is accomplished. It wasn’t until 2021 that there was a glimmer of optimism that Congress might consider disability discrimination. Hospitals around the nation still refuse to transplant organs to people with intellectual disabilities because they cannot take good care of themselves, which is why no official rule has been put in place to address this issue.

4. Erroneous Trial Findings

An estimated 12 million diagnostic test mistakes occur annually in the United States. Medical mistakes kill tens of thousands of people annually—upwards of 22,000 in fact, according to recent studies. Some of those deaths are definitely attributable to erroneous testing. However, how are decisions made regarding organ transplant recipients when testing is necessary? That, too, has the potential to fail.

After medical professionals discovered that a lady on the transplant waiting list had been drinking, they removed her from consideration. For a liver, that would be a major red flag. If someone is going to ruin the new one you gave them, there’s no use in giving it to them. That was the rub, though; the woman hadn’t even been drinking.

Doctors have a bias toward believing patients when they present contradicting evidence, which is a major obstacle to testing for such problems. They might not be completely incorrect; after all, many patients do in fact tell fibs. While some may, it is by no means universal. The woman’s bladder was actually making its own alcohol, it turned out. Her candidacy for a transplant was reevaluated after further investigation.

3. Usage of Marijuana

At now, 36 states have legalized medicinal marijuana, and 50% of those states have also legalized recreational marijuana. Additionally, its usage in certain contexts has been decriminalized or allowed in a number of countries across the globe.

Despite the fact that it is lawfully prescribed, there have been instances where transplants were denied to individuals who were using it.Liver transplant rejection due to Timothy Garon’s marijuana use ultimately proved fatal. Contrary to what Garon’s attorney had heard, the hospital insisted that was not the only consideration when deciding which patients were eligible.

As a means of alleviating the agony and nausea that accompanied Garon’s illness, his doctor had recommended marijuana. He didn’t even have six months to live, but the hospital nevertheless insisted he stop taking the medicine. His condition was too advanced for the 60-day regimen that was prescribed.

2. Alcoholism Background

The possibility that a person’s drug misuse past could lead to a transplant denial has been brought up multiple times. It is possible to withhold a liver from someone with a history of alcohol consumption. That seems reasonable on paper. A lot of the time, though, it works out to be biased.

An indigenous Canadian woman’s drinking past led to her denial of a liver transplant. Her liver damage was thought to have been caused by acetaminophen; she had a history of alcoholism but was reportedly sober when she had surgery. Even yet, she was turned down.

Additionally, a liver transplant was denied to an indigenous man from British Columbia because he did not comply with the province’s six-month abstinence guideline. Many structural factors, including residential school abuses, poverty, and racist legislation, have contributed to the disproportionately high incidence of alcoholism among Canada’s indigenous population. On those grounds, the challengers argued that the abstinence rule was discriminatory.

Although the event we just cited occurred in 2019, the policy was supposedly revoked in 2018. After the transplant board realized their error, they reinstated the man’s transplant waiting list.

1. Probation Violated by Father

Being rejected an organ because of someone else’s actions is far more devastating than being denied an organ because of your own. That is the fate that befell AJ Burgess, a toddler.

Because to his early delivery, Burgess required a kidney transplant. A spare kidney was available from his father, who was an ideal donor. It looked obvious. However, due to the father’s parole violation conviction, the transplant could not be carried out by the hospital. Prior to conducting the transplant, the hospital insisted on reviewing his parole and probation records to ensure he had adhered to all regulations for at least three to four months.

The good news is that Burgess did in fact receive a kidney transplant after all; a matched donor was located following the public outrage.

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