Should Undocumented Aliens Be On Organ Transplant Lists?

[The Mad Monk]

At this point, the Federal Government does not allow it. Should it? On one hand, these are human beings desperately in need of help. On the other hand, the supply is extremely restricted and hugely expensive, and our citizens and resident aliens are also human being desperately in need of help. The article below isn't a perfect fit, but it's what started my thinking on this.

Protesters demand organ transplants for undocumented immigrants
Posted: Monday, August 5, 2013 9:10 AM EST Updated: Tuesday, August 6, 2013 4:45 PM EST
CHICAGO (FOX 32 News) -

Monday marks the seventh day of a hunger strike for protesters demanding access to organ transplants for undocumented immigrants at Northwestern Memorial Hospital.

There were about 40 picketers in front of the hospital on Sunday, including the 14 people on the hunger strike.

"We're asking for help," said Blanca Gomez, 23, who needs a kidney transplant. "I go to dialysis three times a week. I'm not going off the hunger strike until I get on the transplant list."

Gomez said she had lost four pounds and was surviving on water and Gatorade.

The group said 14 undocumented Mexican immigrants who live in the Chicago area need either a liver or kidney transplant. But they can't afford it because they are denied federal health care. They are not U.S. citizens.

The protesters said they would stay until Northwestern Memorial CEO Dean Harrison agrees to a meeting.

Northwestern Memorial Hospital is one of the only hospitals in the region to offer live donor liver transplants.

The situation boils down to a moral and ethical dilemma, said Dr. David Ansell, chief medical officer at Rush University Medical Center.

"One the one hand, the intent of the national transplant registry is to base transplants on who needs them most, but there are indeed a whole group of people who find themselves shut out," he said. "And these are people who are uninsurable, and it creates an ethical dilemma of doing the right thing against the extreme cost of doing a transplant."

An average kidney transplant can cost between $100,000 and $200,000, Ansell said. The care needed before and after surgery, in addition to medication, can cost tens of thousands more.

"These are people who contribute to the community. The answer can't be no access, but it's going to require calling together all the transplant centers in the region, as well as politicians and members of the community to find an equitable solution," Ansell said. "The other thing to note is that 20 percent of organs come from uninsured people, but around 1 percent of organs go to uninsured people who need them. These people donate the organs, but mostly don't get access to them."

Northwestern Memorial Hospital issued a response to protesters and hunger strikers who say local hospitals are discriminating against immigrants in this country illegally.

The hospital said its organ transplant decisions aren't based on whether a patient is a U.S. citizen or in this country illegally.

The hospital says all transplant decisions are based on several factors, including the patient's home life, social environment and ability to pay for costly treatment.

The protesters met Monday with a Northwestern representative and say the hospital has agreed to participate in an ongoing dialogue about the issue.

They are now focusing their protest on another area hospital, Christ Advocate in Oak Lawn.

The Sun-Times Media Wire and the Associated Press contributed to this report.

http://www.myfoxchicago.com/story/23045865/protesters-demand-organ-transplants-for-undocumented-immigrants

[snoopy369]

My feeling is that they probably should be allowed access, but not at as high of a priority; for example, the 23 year old probably should be higher priority than the 70 year olds who aren't likely to survive the transplant anyway, but lower than other otherwise healthy 18-55 adults. One equitable solution, though, might be to make a deal with Mexico - if their government will pay for the transplants we do them.

[SlowwHand]

Of course they shouldn't be allowed.

[Sava]

Of course they shouldn't be allowed.

Only a communist would be opposed to the free flow of labor across international borders.

[Sava]

or some racist texan mope

[PLATO]

This really is a difficult question for many reasons, but I do believe that you can't do it. To do so would encourage people illegally crossing boarders just to get on a list. The U.S. healthcare system is under enough strain as it is and it is only likely to get worse with many more people obtaining coverage next year.

[giblets]

Can they donate organs? If yes, they should be eligible to receive them too.

[MRT144]

This really is a difficult question for many reasons, but I do believe that you can't do it. To do so would encourage people illegally crossing boarders just to get on a list. The U.S. healthcare system is under enough strain as it is and it is only likely to get worse with many more people obtaining coverage next year.

Making it Mexico's problem isn't really help us or humanity.

Call me a commie but I definitely disagree with the premise that life is only reserved for americans that can afford it.

[rah]

Just like any other donors they should be allowed to designate a class of recipients. While I slightly agree with the fear that some may gain illegal entry just to take advantage of the system and I don't want to encourage that, I see no reason why illegals that are on the donor lists can't designate that the recipients should be illegals. That seems fair.

[Lorizael]

Making it Mexico's problem isn't really help us or humanity.

Call me a commie but I definitely disagree with the premise that life is only reserved for americans that can afford it.

Life isn't only reserved for Americans who can afford it, but America has finite resources and its first duty is to its people. If you think its duties should be to people who aren't American, feel free to change the constitution.

[MRT144]

Life isn't only reserved for Americans who can afford it, but America has finite resources and its first duty is to its people. If you think its duties should be to people who aren't American, feel free to change the constitution.

We're only tapping a small amount of the finite resources we have in America. I dont believe that the number of doctors is the biggest factor in what makes health care unaffordable to americans and immigrants alike.

[PLATO]

Finite resources really is the issue to me as well. It has nothing to do with income or affordability. The system can only handle so much.

[PLATO]

We're only tapping a small amount of the finite resources we have in America.

WRT to organ transplants? I don't think so. They are scarce enough now. Unless you are talking about compulsory donation...but that is a whole different can of worms.

[MRT144]

If we're talking organs, yes, there are finite amount of organs out there. But solutions to organ shortages are stunted because of resistance for whatever reason to donate more organs. I dont care who gets these organs so long as someone does. To me, it doesnt matter if you're an american or not if you've extended the effort to get here, live here and have the acumen to get on an organ list.

[snoopy369]

It's clearly more complicated than that, MRT. There is a shortage of organs (hence, lists). There is a shortage of doctors to perform the transplants - especially with difficult transplants (Kidneys are one of the more difficult ones, all those blood vessels to tie in). Transplants cost a lot - there are a lot of drugs you have to take to not reject the transplant, fairly long term care afterwards, etc. Once a hospital performs a transplant, they're probably required to perform the long term care - which is very expensive.

Assuming you are asking this question without adding in "and also massively change how the US Healthcare system works", which would really be a different question, the simple fact that there are limitations in terms of cost and time _are_ important. This is why the "death panels" argument always struck me as idiotic. Yes, it was a great scare tactic. But it's also fundamentally flawed: we have scarce resources, therefore someone MUST make decisions with regards to those scarce resources, and some of those decisions do involve deciding one person lives and another dies. Such is life, and that should be something Republicans understand better than Democrats if anything.

Plato's comment about avoiding perverse incentives is very important here, also. Transplants are very difficult and expensive, as well as limited, everywhere. Allow illegal aliens them by default, and you have a huge incentive for people to come here illegally when they're denied a transplant somewhere else. That's very different from an illegal alien who's been here 30 years working the fields and just screwed by our mildly racist immigration policy; but it's very important to realize that both would be affected by your policy. Perhaps you could adjust it so that people are required to have been here for a year or something - but that's hard to prove if you're here illegally in the first place, isn't it?

This really is a very different discussion than the "give people access to hospitals" discussion. Basic healthcare isn't nearly as expensive and not nearly as limited. It still has an effect - it raises the cost of doing business for hospitals, which raises the cost to the taxpayers and the cost to the other patients. But it's clearly solely monetary, and not nearly as limited by physical constraints. Organ transplants are massively limited, and already the source of quite a bit of difficulty.

Add to this the concern of deportation, also. Illegal alien receives a transplant. A month later he's deported (unrelated, just happens to get caught in a sting). He heads back to Mexico, he's probably going to die - perhaps on the way there - because he needs the care he got here to avoid rejection. Perhaps Mexico helps him out there, but especially if he's heading somewhere worse, in Central America or something, he's definitely screwed. Now the hospital has some responsibility to someone they can't even properly take responsibility for...