Sunday, December 14, 2008


Riding my indoor bike in front of the TV, working on my own heart, I saw that the owner of the Carolina Panthers, age 72, is awaiting a heart transplant. I'm sure he's a nice guy.

Until we have so many extra hearts that they're being thrown away, seventy-two year olds ought not be getting them. Football team owners are among the very wealthy, so I assume he can and/or would pay every nickel himself. Even so, it's not right. Whereas it brings up that age-old question about whether the wealthy ought to get better medical care than the not-so, and whereas I'm not entirely unsympathetic on one level (the level that says rich people get better cars and bigger houses), medical resources are finite, and getting finiter. No matter if he plans to leave a big tip: unless everyone under fifty already has one, he shouldn't get a heart. That's not just rationing: it's morality.



  1. Sid, I agree with you. It is heartening (pun intended) to find Tom Daschle at HHS. He is advocating a health rationing system similar to that of the Brits as he begins work on universal healthcare coverage.

  2. Pssst Sid,
    You're not God.

  3. I happen to agree. There needs to be some "boundaries" set for both beginning and end of life care.

  4. I would say I agree in principle, but you know as well as I that there are many 72 year olds that are significantly more healthy than 50 year olds (or 40 for that matter). I don't know the specifics of the owner of the Panthers, but if he's healthy and has minimal other problems besides what is necessitating a transplant, then I am not against it.

  5. Touch one.

    Of course you're right, but how does one set up the guidelines?

    I vaguely recall being introduced the conudrum when in 6th form - when philosophy and ethics left be bored stiff.

    Is it wrong to give a new liver to a rich alcoholic, if they pay enough for it to pay for the healthcare of another person too? Two more? Five more?

    It must be possible to put together some sort of return-on-investment together to sort the recipients in the database once tissue compatibility has been determined.

    I'm a registered donor, and should I die sufficiently abruptly before I've run down my innards, I certainly hope that they'll go to people with better prospects of putting them to good use.

  6. Sili: of course, yours are the essential questions, which I admittedly glossed over. Setting up such guidelines would be nearly impossible, which is among the reasons that rationing is like the third rail. I'm old enough to recall that in the early days of dialysis, and, later, of kidney transplants, there were committees formed to decide on each case individually: medical people, clergy, community members, social workers, trying to give thumbs up or thumbs down on an actual individual human being!

    It's one thing -- and hard enough! -- when it's simply a matter of economics: how much money do we have to spend, and on what should we spend it? It's quite another when it's about barely available organs, especially hearts and livers: that would seem to demand restrictions even before we get around to talking money.

  7. I wanta be there when you tell Clint Eastwood he can't get a new Heart....

  8. Mickey Mantle's liver transplant. 'Nuff said.

  9. Well, see there Frank, that's the nub of it: if we're ever gonna get serious about health care costs, there'll have to be that much touted "national conversation," in which such rules will be accepted as policy. So Clint's place in line is not in question.


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