• When you deny a kid a heart transplant, you better have a good reason why – ctd.

    This is a follow-up to my post on Monday. It appears the hospital has reversed course:

    According to Stokes’ family, Children’s Healthcare of Atlanta at Egleston reversed course this afternoon and has agreed to add the 15-year-old to its donor list. The decision comes days after the hospital officials sent the family a letter saying Anthony would not be a good candidate for transplant because he had a “history of non-compliance.”

    “We met with hospital officials about 30 minutes ago,” family spokesman Mark Bell said this afternoon. “After reviewing the situation, they said Anthony would be placed on the list for a heart transplant and that he would be first in line, due to his weakened heart condition.”

    Bell said hospital officials did not offer a reason as to why they changed their minds.

    Actually, I wish they would offer that reason. I believe there are legitimate reasons to refuse a transplant, and if they had one, they shouldn’t be afraid to say it out loud, in public. If they are afraid to say it, then they probably shouldn’t deny the transplant on the basis of that reason. They did say this:

    A spokeswoman at Children’s Healthcare of Atlanta at Egleston, where Stokes is receiving treatment, would not comment today on the specifics of his case, citing patient privacy rules, but said there was some “misinformation” circulating.

    I, for one, would be happy to clarify any such “misinformation”. We’ll see if they get more specific.


    • Why just a “kid”? Everybody has the right to the healthcare treatment he can afford and no hospital should be given the right to decide whatsoever. They are the servants of the people. It’s like giving the janitor the right to decide what to clean or the gardener what plants to water.

      • There are a limited number of organs available, and there’s a clear way we distribute them. This is not about insurance or payment.

      • What Aaron said. Also, I’m not a “servant of the people”. We have to be allowed to do our jobs and make decisions without fulfilling everybody’s fantasies.

        The transplant isn’t just about the organ, it’s also about sticking with the regimen of post-surgical therapy. What if the patient in question had significant history of such behavior? That doesn’t make him evil, but it makes it harder to justify the potential waste of an organ on the non-compliant when others may adhere better to recovery.

        I know nothing about the case and am not commenting on the boy and his family, who are surely going through hell. But there’s nothing unethical about including treatment adherence behavior in allocation decisions.


      • Are you being purposefully obtuse? You strike me as one of those rocket scientists who understands partial differential equations but fails at basic logic and common sense.

    • I trained at what is now CHOA in the 90’s and they used to give many kids organs (kidneys back then) who shouldn’t probably have gotten them and we dealt with the repercussions of rejection even mos after transplant and then dealing with the families, do they get more organs, etc. There must be something more going on with that.

    • Wouldn’t the hospital giving a reason for denial in public likely be a HIPAA violation?

      • That’s an excellent question. Ironically, I don’t think so. It’s likely not PHI, if it was an arrest record, or poor grades. I imagine, though, that decisions that involve organs might need to have some public information. Maybe someone else here knows?

        • Poor grades or an arrest record alone don’t seem like great reasons to reject a candidate for transplant in that they would seem like discrimination.

          Noncompliance would seem to be the outdated term for non-adherence to a medical regimen. But in the article below, his mom seems to be alleging that he had not had a treatment history for this disease, and somehow the doctors found that he was nonadherent. I am left wondering if there is something more, but right now we can only speculate.


          The article