Selkirk said she and Allan are both discussing a legal challenge to the liver transplant guidelines for those with alcohol use disorder “with people who have their own living donor.” “It’s not fair and it’s not right, and hopefully we’ll change that policy,” Selkirk said.
Even if her apartment could donate his own liver, it should still go to a better recipient. If anything he should be donating anyways to honor her and save a life
You (or the committee of doctors) don’t decide who is a better recipient for my goddamn organs. You can make whatever the fuck ethical decision you want when I’m dead, but not until then. And I’ve gotta say, it’s shit like this - treating patients & donors like you know better - that make me not want to be a donor anymore. If I wanna donate my lungs to Hitler because he’s my grandpa and I love him, that’s not something you get to have a decision on.
The fact that people are down voting you for saying in essence “my body, my choice”, is ironic for lemmy.
my body, my choice
It’s a bit more complicated than that with transplants. Should people for example be able to sell their kidney to the highest bidder? That’s also “my body, my choice”. And should doctors be forced to participate in such a scheme?
A transplant system should consider fairness, equality and possible abuse. Obviously I think it should be possible to donate to a loved one, but we should also be careful not to create a system where the rich get priority, because they can pay more, and where poor people could be financially pressured to give up their bodily integrity by having to sell an organ.
Not really. All political factions try to sound like they are about principles when in reality they are about tribes.
Doctors are cops. Pass it along
My apartment only bring me debts.
Even if her partner could donate his own liver, it should still go to a better recipient
That’s nonsense, because the partner would not donate his liver if it went to someone else.
Right? Like I would donate my liver to my kid, or my spouse, without even questioning it.
But if the doctor told me they can’t have it (for some reason other than incompatibility), and they died? Fuck them. I’d de-register as an organ donor out of spite.
Donating an organ is a pretty invasive operation that can have a lot of complications, doctors aren’t only taking the recipient health, but the donor too, in the equation.
We’re explicitly talking about a situation where the donor is suitable. So I don’t know what kind of information you’re trying to add here.
Even if the donor is suitable, the operation to extract the donor organ is invasive and can have complications.
Maybe he should, but maybe he is thinking “Fuck them, we tried to participate in the system. We had a living donor to go. What? Oh you have a ‘better’ recipient? Well, guess who doesn’t want to donate to a system that failed my loved one.”
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it’s* their fault
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There are more people who need transplants than there are organs, so the medical profession has to make decisions about who to deny. This was a reasonable decision, in my opinion.
In Canada, drinking more than 3 drinks per week is medically considered “high alcohol use” for a woman… (6 for a man). This limit keeps getting lower year after year
If this can prevent you from getting organ transplants, then it encourages lying to your medical doctor about your current habits… That lady was not considered alcoholic, she just used alcohol in greater amount than the limit considered acceptable by doctors.
Latest stats show that almost 4 out of 5 people has exceeds that limit at some point in their life. This woman died only because she was honest with her doctor about her alcohol use. (Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol. It’s not about lacking donors.)
The only genuine hint to the real reason of the refusal was “minimal abstinence outside of hospital”.
Let me ask you bud, if you needed a liver transplant to continue living, would you have even one drink per week, or would you just quit completely?
Very biased article.
Plus, regardless of her husband being compatible, it still costs the state tens of thousands for the operation. In no way would it be ethical to put a new liver in someone who refuses to completely abstain from alcohol.
That’s absurd. Refusing someone a transplant because they used to drink more than 3 drinks a week before they knew they even had liver problems is completely absurd. Calling her an alcoholic for that is even more absurd. What in the world are these people or you thinking?
Are you on purpose missing the point?
The point the person you replied to made is that she didn’t completely stop drinking alcohol once she was diagnosed to have a terminal liver disease due to alcohol use.
So first of all, she must have drank a lot more than 3 drinks a week to have terminal liver disease in her 30s that’s due to alcohol (yes, all of that is in the article)
But the issue is she didn’t stop drinking after being diagnosed, she reduced her consumption but didn’t stop it.
If any of the above is incorrect, feel free to correct us, but making a point that’s completely missing the facts that are being talked about here doesn’t add anything to the discussion.
The first point is correct. The second one is shown to be wrong in the second paragraph.
The issue here is you need to have stopped 6 months or more before, and she was only diagnosed 5 months before she died.
“minimal abstinence outside of hospital”. That means she was still drinking.
This woman died only because she was honest with her doctor about her alcohol use
No, and it even says so in the article
She quit about 5 months before her death when transplants require 6-12 months of sobriety. She was drinking regularly with the fucked up liver before that diagnosis, and liver damage isn’t something that just suddenly appears.
She kept drinking despite what would have been intense cramping pain and a slow death, thats why she was denied (addiction) and ultimately died
Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol
And as the article also says it’s incredibly dangerous for someone to get a live-donor transplant when they’re in bad shape like she was, as failure of that means they’ll need to let her die on-table or transplant a good dead one into her (which she was denied for, due to her drinking)
It’s sad, but this woman died to alcohol abuse, pure and simple
That’s a lot of vague statements you’ve repeated from the article. What’s drinking “regularly” (this was before the diagnosis as you’ve stated)? “She kept drinking”, what does that mean? How much alcohol was she consuming? Did she have a sip of her friends wine and was honest about it so was rejected?
as the article also says it’s incredibly dangerous for someone to get a live-donor transplant when they’re in bad shape like she was, as failure of that means they’ll need to let her die on-table or transplant a good dead one into her
Where does it say that? You’ve completely twisted the statements.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day, A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
In 2021, 15.6 per cent of Canadians over 12 engaged in heavy drinking – a term defined as five or more drinks for males, or over four for females, on one occasion at least once per month in the past year.
Heavy drinking is drinking ONCE per month in the past year. If this is based off of before her diagnosis, you’re gonna exclude like 80% of the working population who actually does go out for drinks or private occasions (unless they just lie which I guess they should’ve in this situation). Between the price of keeping them alive but not fixing the problem and there being no “review” process for decisions, I would categorize this as a bad system that allowed a preventable death from an alcohol related disease to continue.
That’s total bullshit. As a IT professional I have a nightly drink after work for self medication. Never two. Just one.
Just do what I do and put it in that deep cupboard above the fridge. Then forget about it for literal years by mistake. It’s doing wonders for my health. Just wish I could do a version of that for my bad sleep schedule.
I’m guessing you can stop at any time if you want to? I’ve known older healthcare professionals that have approved and even encouraged one drink a night, but our understanding of the effects of drinking has evolved. I doubt doctors keeping up with the science would encourage it at this point. It would be like having someone come in that’s overweight. It doesn’t mean you’re unhealthy now, but it may be a factor that needs to be kept in check and working on it could prevent issues in the future.
Yes I can and have stopped. I drink 2-5 times a week and it’s one 40 proof 1oz (not a shot 1.5oz) over rocks with a bit of soda. Same or less than a beer.
This isn’t two shots neat daily or a six pack of beer. Sometimes I go a week without. Other times it’s 5 times a week.
Just remember if a doctor ever asks then lie and say only on friday, there’s a few things in life you absolutely have to lie about because the system is not designed to care about people.
Here in the uk never admit to smoking weed to a medical professional, never admit to even so much as thinking about any form of self harm, delusions, emotional regulation issues… it can come back decades later and fuck you over.
This is generally pretty bad advice.
I mean I get where you’re coming from, and I cannot speak to what it is like in the UK (I can only speak as a man in the US), but you should not lie to your doctor.
If you see a doctor, and they start treating you differently after finding out that you smoke weed, then you find another doctor.
Unless you’re in Canada and there’s a doctor shortage and you can’t just shop around for a different family doctor if you don’t like your current one. If you’re lucky enough to even have a doctor here…
Wait what happens if you admit to smoking weed? I thought we had doctor patient confidentiality. I’ve had some mental issues in the past, though not to the point of self harm. What happens if I admit these? I also live in the UK and this is concerning.
I’d be inclined to agree, except that her partner wanted to donate HIS liver and was prohibited from doing so as a living donation due to the alcohol use determination.
As an alcoholic, I initially agreed. Don’t waste a liver on me. Then this:
Even pleas for a living liver transplant, with Allan offering to be her donor, were not entertained.
What the actual fuck.
It’s not like giving away part of your liver is a zero sum game, now that person is at risk of infection, has lesser liver performance, and for what? Someone who has showed they will just continue to harm themselves, and others (the person they’re getting the liver from,) if you allow it?
I don’t know any other surgeons who would do that.
Has lesser liver performance? What? Do you understand how a living transplant works? You both regrow a full liver after the procedure, because livers are so regenerative you can make a full one from less than half. This makes no sense to me.
Also she quit for 5 months after she found out she had liver failure.
It takes years for a donor’s remaining liver to grow back, and the recipient is unlikely to grow out more of the donated liver depending on comorbidities and severity of illness.
If a surgeon refused to let me save the life of the one person in the world i love then they wouldn’t be able to save any more lives after that so add that to your heartless calculations…
There are very few transplant surgeons who would take the risk of a partial liver transplant which they have high likelihood of being a death sentence for the patient (not sure if you read but they need a full liver, from a cadaver, not partial,) and want to willingly throw their name in with another patient to discuss during M&M.
This is coming directly from familiarity with the procedure, comorbidities, and other factors from a general surgeon at a top 10 hospital in the US.
Yes these people should indeed be killed for letting another human die for no good reason.
I’d have supported her paying out of pocket to use the live donor that was willing, but not to use my tax money when it’s pretty fucking clear she has no intention of changing.
It’s the same reason I’m largely against the Liberal’s diabetes funding - ~90% of diabetics are Type 2 (I’m willing to help Type 1’s out because it’s not their fault) and the vast, vast majority of those are from unhealthy lifestyle even if they are genetically predisposed.
If were going to have a public health system, people should be required to take care of themselves. And no, I’m not talking about the one-off accidents from riskier activities (although I do think people should bear the cost of their own healthcare if it’s the result of criminal activities), I’m taking the problems that occur as a result of abusing your body for years or decades.
So I drink more pop than I should. Why should I have to pay more for my healthcare than my buddy who had a habit of timing running green lights as soon as they turned green. That isn’t illegal, either, yet it’s very risky behavior. It didn’t work out for him just one time, and he nearly died. Why should taxpayers have to pay for him?
The answer is because the vast majority of us engage in risky behavior, or just have the bad taste of passing on our poor genetics to the next generation, and the social cost for penalizing people for not agreeing with societal norms are too high. This includes drug use, even legal ones like alcohol. Sure, don’t spend limited resources such as donated livers on people who aren’t willing to make the lifestyle changes required to make it worthwhile, because someone else will probably have to die for that to happen. But if we could make new livers and the price was reasonable, I wouldn’t even be against that.
You should pay for their healthcare, because you have a contract with an insurance company.
What makes you think that I, posting in a Canadian community about a Canadian article, have a contract with a healthcare insurance company?
oh, sorry, there was much talk about public health insurance, i Of course don’t have a clue how that works in canada. sorry, my fault. I only focused on public health care, here in germany thats an insurance, i was ignorant.
Not a problem. It’s essentially rolled into our taxes for the most part in Canada. You may have health insurance on top of that, but that isn’t a guarantee and usually is a top-up of our universal coverage. This usually covers things like drug prescriptions, glasses, and hospital conveniences such as semi-private or private rooms. I agree with the general idea, though, that we as a group pay for everyone who is covered. My original point at the top of this thread is that removing people’s eligibility simply because of risky behavior can be very tricky and likely harmful to society.
If your buddy who likes gambling with green lights was convicted of a traffic offence as part of that accident he should have been on the hook for his own healthcare and the healthcare of anyone else he hurt.
Way to miss the point. It’s a good thing you don’t engage in any risky behavior, or anything that would have a negative impact on your health. I mean, it’s not like you would be a hypocrite, right?
I never said “Don’t engage in any risky behaviour”. Stuff like cardiovascular and lung diseases and Type 2 Diabetes doesn’t happen over the course of days, weeks, or months, you have to be chronically treating yourself like crap for years to get to those points.
Free climbers don’t usually die the first time, either.
Until there is a diet that has long term success for a majority of its users I don’t think this mindset is healthy or realistic.
“According to the latest weight-loss research, 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss.” source
If were going to have a public health system, people should be required to take care of themselves
On the face of it, this sounds sensible. But, thinking more deeply, who should decide the required amount of care a person ought to take? Ideas about what it means to ‘take care of yourself’ are varied. And consider that some citizens of this country are simply unable to take the same personal health decisions that others have the privilege to take without a second thought.
What you’re talking about here isn’t a public system. A healthcare system that only serves certain chosen people is not public in any meaningful sense.
A public healthcare system is imperfect on the whole, but on average, when funded and administered properly, is structured to apportion care based on need, instead of the profit motive. I think that’s worthwhile, and the right thing for a society to do from a moral standpoint.
no one bothers that it is THE PEOPLE that pay for their health insurance, not the state.
the state made insurance mandatory, thats the only thing it is guilty of.
Thats a dark road to tread.
An example,
no alchol consumption is safe, so using your line of thinking you’d need to argue that anyone who partakes of alcohol at any anytime would fall under that line of thinking
Processed red meats simailary, especially those treated with nitrites, so those eating bacon, ham etc shouldn’t be entitled to public heath care under your reasoning
Or are those things ok becase you do them ?
On the upside, now you’ve excluded 95% of the population, public healthcare will be cheap :)
Contra to most peoples thinking, if you’re concerned about public healthcare costs, you should “encourage” obesiety and smoking, they all die early, most health care coats are associated with healthy people in their old age. See here
https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html
Adults are stupid and greedy, we all are.
it does not cost the state A DIME, because it is insurance that covers healthcare, not taxes.
The loss is unrealized potential of those who are sick. so, that means the state invested like 150.000 bucks in one citizen, in hopes to get like one million bucks out of them
(not out of them specifically, but out of their labour; it is a chain, you see, and the labourer pays taxes, the factory pays taxes when selling the product, the consumer pays taxes when buying the product, and so on)
alcohol and obesity by diabetis harm EVERY cell in your body, period. thats hard biochemstry, facts, it is the truth.
red meat, on the other hand, is quite unclear.
the studies involving red meat are interesting;
people self report by remembering long periods of time, a salami pizza counts as red meat, as does a whole mc donalds burger with fries on the side.
as for nitrate, this gets complicating. you seem to be on the right path. nitrates are a new topic for me, i never before read up on them:
https://www.diagnosisdiet.com/assets/images/5/nitrate-content-45165560.png
https://www.bbc.com/future/article/20190311-what-are-nitrates-in-food-side-effects
this is so tedious, no wonder everybody has a different oppinion
Perfect, let’s just get rid of public healthcare then
Threads like this always bring out the uninformed. It’s great. Easy to block them. Fish in a barrel.
What a shitty attitude.
You’ve gotten a lot of downvotes but rather than doing that I want to explain to you why your position here is flawed.
First think of every lifestyle activity whether it be food, motorcycle riding, music, etc. Now consider that there are some activities that are statistically safer than others.
If we took your position to the point of being law why would we stop at food lifestyle choices? Why not just any risky lifestyle choices? Eventually you end up with a society where individuals have less choice and freedom and are constantly obligated to live the safest possible lives.
You and I both know that isn’t a desirable outcome. We should be empowering people to live the lives they choose and encouraging them to be healthy, not punishing them for make the “wrong” choice.
I attempted to address this but perhaps I wasn’t clear:
Yes, some activities are risky then others, however many of them have absolutely 0 negative impact on you unless something major happens all at once. In fact, many of them have major health benefits for the vast, vast majority of participants.
Contrast the above to overeating, chronically eating stuff that’s not good for you (ex. excessive sugar, salt), drinking too much, doing lots of drugs, smoking… that kind of behaviour will basically screw up everyone who partakes given enough time and has no positive health benefits at all.
You talk about a loss of freedom… I’ve already lost freedom by paying for a bunch of people who purposely fuck themselves up for no tangible benefit to themselves. There is stuff that would be good for me that I literally can’t afford because of the amount of taxes I pay.
Here’s an idea for your route of encouraging healthy lifestyle rather than removing freedom: include a physician form in my taxes where my doctor attests that I am generally in good shape (given my age) and he has no reason to believe I am doing anything that is a risk factor for chronic cardiovascular or lung diseases, diabetes or related chronic illnesses, and give me a significant tax break for doing so.
Consider what you just said can apply to motorcycling or buying a classic car with outdated safety features. There is no tangible health benefit to motorcycling or driving a classic car, it basically “has no positive health benefits at all” (as per your own words) and only increases risk. Show it be banned? What about every other risky hobby? If not, then neither should eating junk food which is measurably less dangerous/risky. Keep in mind that for smoking the overall trends of diminishing smoking habits in younger generations basically highlights the proof that encouraging healthy habits rather than punishing the individual is the correct way to approach this.
Buying a motorcycle or classic car doesn’t necessarily lead to injury in the same way that overeating and being lazy to the point of becoming a land whale does.
Being a judgmental asshole increases your likelihood of being assaulted. I shouldn’t have to pay your medical bills when you get punched in the face by a stranger.
Free expression bud, it’s my right to be a judgemental asshole. Take that up with Pierre Trudeau.
I suggest you look up just how often motorcycle injuries/deaths happen. What you’re saying only applies if you never get into an accident or fall off the bike ever, in the entire period it is owned (which could be 20-30 years). Something which is incredibly unlikely. From the language you’re using (i.e whale) I’m getting the impression that your position isn’t rational and instead based on a dislike of overweight people. I’ve done what I can here but I don’t think you’re messaging back in good faith and don’t want to entertain the perspective of someone who tries to put others beneath them based on their body and eating habits.
I’d be willing to bet that the number proportion of motorcycle owners with health problems caused by riding is a hell of a lot lower than the proportion of people who don’t eat right and don’t exercise enough and have health problems linked to that.
And no, it’s not just overweight people I don’t like, it’s also people that are sick all the time (like, weak immune coughs and colds type of stuff).
Right now you’re on the internet instead of being physically active, that’s a health risk.
Who says I haven’t already gotten enough exercise today?
You’re aware of the concept of overworking your body, right?
Who says how much it’s acceptable to eat or drink?
I don’t care if you’ve gotten enough exercise, you would be healthier if you were walking around the block right now instead of sitting inside on the internet. Since my taxes pay for your medical bills I get to tell you how to live your life, so get walking!
come on guys, step over your ego.
Great, so maybe you can stop paying for my healthcare and I can stop paying for yours.
Takes up valuable hospital times
No. A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor. But she wasn’t eligible, so a partial transplant was just a death sentence.
A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor, or she would die in operation.
Since she wasn’t eligible, a partial transplant was just a death sentence.
They said it was viable in the early stages, and with a decent success rate. Just not the success rate they wanted, and for some daft reasons you need to be eligible for a full transplant from a dead patient to get a partial transplant from a living donor. Makes no sense.
Liver failure is terminal. She was invariably going to die without the transplant. She wanted to receive the donation, her donor wanted to donate. If the success rate for a living transplant is zero that’s one thing, but that’s not being claimed here since she wasn’t eligible for procedural reasons.
It’s incredibly sad to hear someone die of a preventable cause this young, but I can also somewhat relate with the people who reviewed her application.
If a living donor wouldn’t have been sufficient, they’ve now created two patients where they previously had one, and without improving the primary patient’s condition. It makes sense that a donor organ from a deceased donor would be preferable.
That said, the current requirement for the patient to meet deceased donor standards for transplantation to be eligible to use a willing living donor make no sense. Both situations should have their own unique criteria, given that a living donor situation involves different risks for both the patient and the donor than a deceased donor situation would incur.
Ultimately this whole situation boils down to a scarcity situation though. If we want to solve this, it will require more people to register themselves as a donor and a review of the eligibility criteria as soon as more donors are available.
And how prevalent and socially acceptable Alcoholism has become.
It’s not just acceptable, it’s encouraged by the province to keep people from rage quitting their lives here.
I thought this was about kidneys instead of livers and was very confused.
I’ve known entirely too many alcoholics that have had too many wake-up and come-to-Jesus moments, only to go back to drinking as soon as the immediate crisis is over. Change only comes when the alcoholic wants to change for their own reasons, not due to external factors.
Livers are a limited resource. Wasting a donor’s liver on a person that
usis unlikely to stop drinking–despite their protestations–means that another person doesn’t get one. It may seem like a cruel calculus, but it’s the only reasonable way to ration a scarce resource. It doesn’t matter if alcoholism is a disease, or you think that it’s a moral failing; the end result is the same.This was my initial opinion until I read the whole article.
“I got my blood tested, I had MRI scans, I had a CT scan, I had ultrasound and blood compatibility test with her. I was a match,” said Allan.
Transplant guidelines in Ontario and much of Canada require patients with ALD to first qualify for a deceased donor liver. If they don’t meet that criteria, they aren’t considered for a living liver transplant, even if one is available.
Her partner was a willing, compatible donor, wanted to give her his liver and was prevented from doing so. So yes, this is a cruel take.
If you keep reading it gives a reason why this is a requirement. Now whether you agree with the doctors or not is up to you but there is at least a reason for this.
But doctors say that people with severe liver disease from alcohol use may need more than just a partial living liver donation to thrive.
“The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor,” said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
From this, the reasoning appear to be this: there is a high risk that the living liver transplant will not take. In this case the patient may be at risk of dying instantly and thus need another liver transplant. Since the candidate doesn’t not qualify for this other transplant, in the case where the transplant does not take, the patient will die instantly. This is in contrast with the patient being terminally ill however given time to live out the remainder of their life.
I guess then the question should be is that worse than definitely dying now, and where does this cross into the patient having the right to request their own treatment?
I will always defer medical guidance to medical professionals, I know nothing in comparison to them.
It is worse.
If the living partial liver doesn’t take hold, it dies off and becomes necrotic, and would need another surgery to take out or it’ll become necrotic and they’ll die of sepsis. It’s also unlikely they’d survive such second surgery, due to the already existing liver failure + first surgery trauma.
In this case, you’d be asking doctors to directly kill the patient in a more painful way for a very tiny chance that it may save them, on top of if they do survive, assuming they don’t relapse into alcoholism and die anyway. All while technically injuring someone else (the live donor).
Thank you, that does sound like an awful way to die.
I try to never assume I’m smarter than others for seeing the “obvious” path. I had a coworker in another department once call me out for saying “why don’t you just” and it’s stuck with me since.
This is a bunch of CYA from the hospital that got a woman killed. The article talks about how transfer success rates are up around 80-85%. That’s just for the 6% of people who magically fit through all the “qualifications” the hospital has decided determine whether you get to live. This lady had a doner tested and lined up, but was rejected on the “off chance” (read: low probability) that IF the transplant failed, she would almost certainly die without an immediate whole liver transplant. So the fuck what? Her options were to maybe die from surgery or absolutely 100% die an agonizing slow death from liver failure. The hospital took away her ONLY chance at life. This is murder by committee and I hope the estate sues the entire hospital into the ground.
15% failure rate is not low, it’s a dice roll essentially on par with Russian roulette.
Is a 15% chance of death during the surgery lower than the 100% chance of death if she doesn’t get the surgery?
Yes. Yes it is. It is THE lowest possible chance of death she had among her remaining options.
Question: are there any countries where this is allowed? Would they have been able to go abroad and do this operation?
I don’t know enough to be able to answer your question.
However, even if you did find a country you could do this in, you’d have to deal with the cost and time required to travel there, consult with the local doctors, get the surgery scheduled, perform the surgery, and remain for post-op care - all of which would be likely out of their own pocket.
Canada has universal single payer health care system and I have no idea how they deal with medical procedures done outside the country. I highly doubt they would cover unless they were on private insurance that allowed it.
Not everyone has the means to do what you suggest unfortunately.
As someone else already pointed out, if the transplant from the living donor failed or had complications, now you have two people that need livers. It puts a healthy person at risk for a very low chance of a positive outcome. If they were paying out of their own pocket, then I’d say sure, go ahead, blow your own money on it, risk your own life and health. But they aren’t.
i think they’d fall under renewable resource
I don’t think renewable excludes it from being limited.
It was a dumb joke and you’re right
Hey, I appreciate your candor and humility. Good on you.
IIRC, there are ongoing experiments with organs are being grown in cloned animals; the animal is slaughtered, and the organ is harvested. Maybe someday they’ll be more readily available and renewable than they are now.
…At least for the wealthy that can afford to have farms of cloned animals.
It will always be insane to me that today’s rich people would rather be less wealthy as long as they are more wealthy than everyone else as opposed to being even more wealthy with everyone else if we all just worked together and had the freedom to create and be innovative.
If you are going to make alcohol consumption a bar to a liver transplant without making alcohol illegal you should all go fuck yourselves. You had a drink and you should die should not be a thing.
This isn’t what happened though. She was addicted to alcohol, per her partner, got diagnosed with needing a new liver, she immediately quit alcohol, and they denied her anyway even though quite a bit of time had passed while she was sober. I am unaware if her liver disease was because of the previous regular alcohol use. It wasn’t just 1 drink though.
Yes, organ donation is messed up. I met a girl dying in hospice once. She needed a new kidney. Genetic stuff, and then when she was 15 she tried to kill herself with Tylenol. She got her first transplant before the suicide attempt. She was denied a second one due to the suicide attempt itself. There are only so many organs in the world. She died in agony in hospice, young and covered in calcium deposits.
We punish substance use and mental health so harshly in this country. No one deserves the death penalty for previous substance use, especially for alcohol which is ancient af. It’s horrible she was denied when there was a liver already available.
It’s horrible she was denied when there was a liver already available.
Any full cadaver liver that could have gone to this woman didn’t get thrown into the garbage — it went to someone else who would have died without it.
As for the living donor liver her boyfriend offered, even though he was a match her level of liver failure likely meant that the partial liver her boyfriend could have donated wouldn’t have been successful. Living donors still need a liver for themselves, and we each only have one full liver — so the best they could have done is given her half a liver. Her condition was too poor for this to have a likely positive outcome, which was why this was also denied.
It sucks, but there aren’t enough donor livers for everyone who needs one. The cadaver liver she was denied however would have gone on to save the life of someone else you’re not hearing about in the press — someone else who may have died without it.
If the unfairness of it all upsets you that much, then make sure you’ve signed your organ donor card, and make sure your family members know and understand your desire to be an organ donor. And encourage the people you know to do the same. This is only a problem because there aren’t enough donor livers for everyone — when you have n livers, at best you can save n lives — and thus having a larger number of donor livers allows for more lives to be saved, with fewer qualifications.
It’s hard to say if she would have lived or not.
I think a bigger discussion about medical gatekeeping and bodily autonomy is warranted here
I have been an organ donor since my first driver’s license
From my limited knowledge organ donation criteria are horribly restrictive on a personal scale but unfortunately make sense on the macro scale. Organs are such a scarce resource that as I understand there’s no other option.
This girl’s death was undoubtedly a tragedy, but as fucked up it’s to say if she lived someone else would probably die in a similar agony. Was she treated fairly - I don’t know, can we make this system better - I unfortunately also don’t know.
Organ donation panels are a sick Trolley problem come to life. I don’t know either.
One easy way would be to make organ donation opt out instead of opt in. As in, if you do nothing, you’re an organ donor if you end up brain-dead, and if you don’t want to, you have to explicitly opt out. Alternatively, we could just say any brain-dead person may have their organs harvested, regardless of what they declared while still alive. After all, you don’t need the organs anymore once you’re brain-dead. (I’m specifying brain-dead, because if you’re completely dead, then the organs are also useless)
That would help to some extent with scarcity in opt-in countries. But there are already opt-out countries which still face the same dilemma. Because if you’re even one organ short how do you fairly decide who’s gonna die… Can you even fairly decide about someone’s life and death…
We punish substance use and mental health so harshly in this country
It’s not punishment, any chronic illness will make someone ineligible for an organ transplant. It’s not saying it’s that person’s fault, it’s a situation of “2 people need this organ, which ever you choose the other will die in agony, one is more likely to live twice as long as the other.”
He was only offering the organ to the one person though
Well this was informative. I will now start lying to my doctor about my occasional alcohol use.
Or maybe read the article?
Occasional alcohol use won’t put you in this situation (hopefully you’ll never be in this situation for any reason)
However, of the reason you need a liver is that you wrecked your own with booze; you are unlikely to get another one
I didn’t see in the article if she self-reported alcohol use, or was tested. I’m responding to the comments here about self-reporting.
She had been an alcoholic since teen years and repeatedly tried and failed to quit
To clarify, I am NOT saying she deserved no healthcare. But donor livers (any organs actually) are a really really scarce commodity. This is why she would not get one
If we had artificial livers (for example), of course she should have received one
Or maybe read the article; she already had a donor lined up only for her. :-D
Omg, again this is like the third time it was posted
The boyfriend cannot give a full liver because he would die. Living donors can only donate a part of the liver. Unfortunately her liver was too far gone and she required a full cadaveric transplant.
Basically the docs saved the boyfriend from losing 1/3 of his liver for nothing
Same for all the people who eat nuts and get hospitalized as well, pull the plug right? I mean come on, they are lesser humans as we stand on our pedistals and look down on them. /S
Genetics play a huge role in liver diseases. 85% of liver replacements don’t come from alcohol. Alcohol in sure is bad for you, but it really is a high horse scenario.
Any source on your assertion of 85% of liver transplants not being due to alcohol? May it be because people with livers blown due to alcohol use would be at the bottom of any transplant list?
I originally was reading studies performed in Australia that the U.S. pitched money to help the studies be larger, they took place around 2012, but here is more information from 2020 where you can see that it say “An estimated 10% to 15% of heavy drinkers progress to cirrhosis after decades of heavy alcohol use.”
Now cirrhosis isn’t the only liver impact that can come from drinking, but my point was that a lot of our “trashing their livers” view is likely because we look down our nose at drunks. Sure they added to it but we aren’t refusing heart transplants to 30 year olds because they drank Pepsi, when we know just as well added sugars/corn syrup does nothing but “trash their hearts.”
https://news.va.gov/82545/genetic-risk-alcohol-related-cirrhosis-uncovered/
I’ll have to find the Australian government article about the 15% being replaced later. I don’t keep search history, auto-deletes
Nah you’re good mate, I take your point. ‘Only’ 10-15% of problem drinkers go on to develop cirrhosis and not a hundred percent of them will go on to trash their livers. You also make a good point about heart transplants not being denied to the obese for example. Today I learnt.
According to the Summary Statistics provided by Canada at THIS LINK, Notably Tables 2A and 2D.
473 were simultaneously on a wait list in December 2023 and either 7 or 8 of them died awaiting transplant.
So I’m not saying it’s murder or anything, just that in order to prolong your selfish existence you’re directly responsible for the death of another. You’re an adjacent-murderer.
But it’s impossible to know how many livers are or are not available at any given time, so absolutely a little morally ambiguous.
Lying about substance use to a confidential healthcare provider is not going to do you any good. If you have drank so much that you are having liver failure, they will know you are lying. If you haven’t drank that much, what’s the purpose of lying? To perpetuate the addiction?
In case I get liver failure for some reason other than drinking, but get disqualified for answering incorrectly.
When has that happened?
As grim as it might be, transplants are handled by apathetic, risk averse math and little else. Loose organs and surgeons are far from common.
Honestly I find that the opposite of grim, I wish more problems were solved in a cold and calculated way.
Like killing disabled people because it’s cheaper, farming slaves to provide cheap labour, that sort of thing?
There a good reason we tend to prefer the more humane and emotionally guided solutions over the mathematically most efficient.
How has Polievre not tried to capitalize on this tragedy to pitch his “your bank is a better death panel than the transplant math” plan yet? American healthcare is half his platform!
He has a platform? Every time I check is just angry “I’m better than Trudeau” statements
I donated a kidney to a friend earlier this year. The reason his kidneys failed wasn’t anything he was at fault for, but even if it had been because of poor decisions he’d made in the past, I still would have given him one of mine. Because people deserve second chances. I can understand not wanting to give a recovering alcoholic a deceased donor’s liver, when someone else could receive that liver, instead. But this woman’s partner was a match and was willing to donate to her. What’s the harm in that? That isn’t a liver that could have gone to someone else who needed it. It’s a donation that would have either gone to her or no one else. No one could have lost out of the donation had been carried out. This was just cruelty, and now someone is dead. And for what? Because there’s a 15% chance (according to studies the article mentioned) that she might have started drinking again???
Surgeon time is precious as well.
So let the free market sort out the organ redistribution problem!
I’m a free market entrepreneur and I’d like to solve your organ shortage and homeless problem all at once.
D:
In the article, it shows that the hospital spent significantly more slowly letting her die than the average cost of the transplant.
The comparison is apples and oranges. They only include the cost of the surgery itself, not the cost of after-surgical care, the potential cost of complications to both the patient and the donor, etc. Then there’s the cost if the partial liver donation doesn’t take, or if the patient relapses.
Obviously, there’s also a lot of potential upside to having the patient survive, I just don’t think the odds of that were all that high.
It’s not super clear, but the article makes it sound like if a partial graft from a live donor fails, then the recipient is automatically fast tracked for a new transplant from a deceased donor.
If that’s the case then maybe policy should be changed in the case of alcohol abuse.
The policy isn’t there just to be extra nice, it’s because otherwise the patient dies without a liver.
Since she was too sick for a partial liver transplant, and not eligible for a dead donor full liver transplant, she would have just died.
It might seem cruel but the same is done for a lot of other procedures; if the chance of you dying in surgery is way too high, doctors won’t take the risk, they’re not executioners.
It’s not a moral judgement about her alcoholism, the same would have been true if she had a cancer no surgeon would take on.
Giving a donor liver to an alcoholic, who only quit drinking upon diagnosis? Hell no.
Did you bother to read the article? Her partner was a match, and could have donated a portion of their liver to her, if approved, as opposed to a donated liver.
Judge someone all you want for their previous life choices, but the decision referenced in this case should have been between the two of them and their doctor.
Did you bother to read the article?
Did you? Her liver was so far gone, doctors did lot believe a partial transplant would work
Second paragraph in: 'However, documents show the Alcohol Liver Disease (ALD) team at UHN rejected her in part because of “minimal abstinence outside of hospital.” ’
The article quotes Dr. Jayakumar making a general statement regarding alcohol diseased livers, but the University Health Network declined to comment on Amanda’s specific case outside offering their (patronizing) condolences.
Feel free to quote the article and back up your statement.
“minimal abstinence outside of hospital.”
This means she kept on drinking while not hospitalized
The rest is standard boilerplate, they can’t speak about her detailed case in public
I’m sorry, maybe I’m just daft this week, but I missed the concept “the doctors believed her liver is so far gone, a partial would lot [sic] work” in that.
I quote: “Huska, he said, stopped drinking as soon as she was diagnosed with Alcohol Liver Disease on March 3 and had also registered for an alcohol cessation program to begin once she was discharged.” So where does the article state she kept drinking while waiting for the transplant?
I’m sorry, maybe I’m just daft this week, but I missed the concept “the doctors believed her liver is so far gone, a partial would lot [sic] work” in that.
This was posted like 5 times and I assumed it was the same article… I’ll find the link to the original one where they detailed this. In any case, she was not eligible because she was likely to go back to drinking and ruin the new liver…
So where does the article state she kept drinking while waiting for the transplant?
I never said that… what the article says is that she was an alcoholic since late teens and was never able to stop. She literally only stopped drinking after she found out she was going to die, and that was only like 3 months. She tried to quit before but never succeeded… that tells you she was a super high risk of relapsing
“This means she kept drinking while out of the hospital”, which directly contradicts the statement by the boyfriend saying she stopped drinking.
Everything else is like, your opinion, man.
Yes, I read the article three times over, trying to chase down false info someone posted in here. His offer is irrelevant. The prognosis was not good enough for him to donate. They only included it in the article for the melodrama. It’s nothing more than an “I would die for her!” moment. Well, I’m glad the medical board did not condone assisting him with suicide.
I completely disagree. People should be able to make mistakes. Stopping upon diagnosis is the best she could have done. If she continued drinking after getting a new liver, that would be a different story.
I hate this “get shunned out of society because you aren’t perfect” culture.
That would be nice if we had an unlimited supply of livers to transplant. Give everyone a chance.
Unfortunately I’d still rather give whatever liver we have on hand to someone guaranteed not to wreck it immediately, because giving her a chance means taking away someone else’s.
No, not in this case, they weren’t taking away someone else’s chance. But you didn’t read the article. Her boyfriend was a match and wanted to donate part of his liver. Donar A wanted to give to recipient B, there was no recipient C losing out. It was a closed loop.
“No amount of determination from the (partner) could bend the decision,” said the physician. “There was no process for a second review or appeal. Just a harsh finality … goodbye.”
She many have not even been the drunkard you all are assuming she was. If you go out once a month, and have 3 or 4 beers, you’re not eligible for a liver transplant. That’s ridiculous. You may not drink the other 30 days of the month, but that one Saturday ruined it for you; you die.
A life was forfeit, because some bean counters in white coats -probably not teetotalers themselves- deemed her not worthy. Even though it cost more to let her die,
Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day
A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
That is because her boyfriend could only give her a partial transplant (he cannot donate his whole liver) and the doctors did not think it would work as her liver was too far gone to recover with a partial transplant
The rest of your comment is so far from reality or logic, I’m not going to bother addressing it
Her partner is the one saying she had an alcohol substance use issue. It’s not “assumed” she was a drunkard, he stated it. I agree she should have been given the liver- she quit alcohol, she had a donor. We shouldn’t punish people with alcohol use issues by killing them.
The liver wasn’t thrown away, it was given to someone else. The liver still saved a life, unfortunately it wasn’t hers.
Unless you’re talking about the boyfriend’s liver, in which case the doctor determined her condition would not survive a partial transplant, and the attempt would just kill her sooner.
I was talking about the general disturbing nature of determining organ transplants, yes I know re: the live donation from her bf
So again: The liver wasn’t thrown away, it was given to someone else. The liver still saved a life, unfortunately it wasn’t hers.
Imagine being the person denied a liver because they gave it to someone with a chronic alcohol abuse problem to “give them another chance”.
Cutting out someone’s liver to transplant isn’t easy nor risk free. You are risking death to have a low probability of saving someone. It doesn’t matter if they are volunteers.
Oh, way to move the goal posts!
Basically - fuck this person, right?
Isn’t it about her chance to get one though? “There was no process for a second review or appeal.”
You have a window were you can’t drink any alcohol for biological safety reasons, but in this case the mere rule of not drinking alcohol was enforced. This makes it a punishment instead of some biological requirement.
Some time ago I had to go under general anesthesia to have some teeth pulled. Local anesthesia didn’t work. I wasn’t allowed to eat for 24 hours. But I was so hungry that I ate just enough to not have stomach pain anymore. In the hospital I said I ate a tiny bit, and they said that it wouldn’t be much of a problem if I only ate a bit. Compared to the OP story, I wasn’t punished because I was still within the safe window.
Why should somebody get punished by a hospital? They should be neutral. “Oh you drank alcohol? You’ll have to come back later because of safety reason”. They shouldn’t be the judge. Giving them that power is just stupid.
Doctors are cops. Acab.
I assume you were not getting a transplant? The risks of regurgitation during surgery is in no way comparable to the risk of relapse in someone with hx alcohol use disorder in early remission. Addiction is a terrible beast. I am sad that she died too, but we have to blame the systems of addiction, not the medical board.
Nope. This seems like a stupid rule.
Transplant guidelines in Ontario and much of Canada require patients with ALD to first qualify for a deceased donor liver. If they don’t meet that criteria, they aren’t considered for a living liver transplant, even if one is available.
It was perfectly possible with her partners liver. This is just “no you didn’t do what we want so we just let you die”, and you’re here trying to justify that.
Medical notes suggest she started drinking in her late teens and had tried – unsuccessfully – to quit. After periods of sobriety, she returned to alcohol, which could increase the risk of continued use after the transplant.
Allen says Huska registered for an addiction program early on in her hospital stay to stop drinking after she’s discharged. Hospital records also say she suffers from anxiety.
From the first article CTV made about this, linked in in the first sentence they posted. Seems like we need to actually fund mental health care in this country or something, because she’s obviously been struggling for a while. You can see how the board would weigh previous failed attempts to quit against her.
I completely disagree. People should be able to make mistakes.
You are allowed to make mistakes… What you are not allowed to do is skip the consequences
It’s not like you can pick a liver at Walmart and give it a try. That liver could save someone else, giving it to an alcoholic is likely to only buy her a tad more time untill she relapsed
My cousin was a raging alcoholic. He got clean, but not before he fucked his liver right up. I don’t know if they even allowed him on the liver transplant list or not, but if he was, he was very low on it. He died in early 2015 at the age of 43.
How long was he drinking? And how much?
Since no one has mentioned it, USA has the same policy basically.
Wait, so if someone was ever an alcoholic - they gonna be denied? Even if they stopped drinking for many years?
Doctor here who has referred patients for transplant. No. You must be six months sober to be eligible for the transplant list. There’s so few livers to go around, they need to be sure the recipient isn’t going to just break the next one.
It’s rare to suddenly need a liver; they usually take months to fail and this gives the patient and doctor months of notice to try treating the failure first (including lifestyle changes and meds) before getting sick enough to go apply for a transplant.
Their boyfriend was willing to be a living donor for them. So you aren’t talking about a scarce resource here.
I used to trust HCPs, but I know many of them now and have heard them shit-talk and judge their patients for mental health issues and drug use (among other things). I would NEVER, EVER tell a doctor or nurse about any form of drug or alcohol use now, or any kind of anger issues that could possibly be interpreted as aggressive. Especially not in a hospital where everything gets recorded in an electronic chart and may be used against you in the future. Fuck that.
I’m sorry you have such a low opinion, maybe you heard someone venting about their job after work?
You really think lying about your drug use is safe? It’s dangerous to give many types of anesthesia if you’re on drugs or alcohol. We don’t particularly care if you use or not, we don’t tell police or family, you just need to be honest so we can do our job correctly.
She literally quit when she was told she had a failing liver that could not recover. Just to be clear, there is absolutely no way in hell that she didn’t know she was on the way to killing her liver with her drinking because there are a plethora of signs long before you get to the point where alcohol has destroyed your liver beyond its own ability to repair itself. (Which is incredibly prodigious. The liver is the single most regenerative organ in the human body)
So forgive me if I’m skeptical that she really would have stopped being an alcoholic after she received a liver transplant.
IMO this was a tragedy of her own making and the money and effort in transplanting a liver would have been a complete waste. (Even one offered by her SO.) Especially when there is such a deficit of available organs and the surgeons who do the transplanting are needed for patients who aren’t likely to go back on the sauce 6 months later.
the pain of a cramping liver is excrutiating. if you deal with that kind of unrelenting never stopping pain und don’t stop drinking, you are addicted for sure.
In most places, if they’ve been clean for 6 - 12 months, they are no longer considered alcoholic in terms of transplantation. Similar to Canada
Notice that they never state she was an alcoholic. They also never atate she was a “high level” alcohol user. Just that she was an alcohol user.
You can make your own assumptions about her alcohol use, but in general these rules would also excluse a “normal” alcohol user with a congenital liver failure…
And for good reason, really. The supply of livers is too small to save everyone who needs them, so they give them to the people most likely to have a successful outcome. Basically every lived given to one person is sentencing another person to death. That’s just reality with supply being what it is.
That’s not true. Living donors can donate part of their liver.
Their boyfriend volunteered as a live donor. They weren’t asking to be put on the general register.
Which was determined to be unlikely to be successful given her condition, so she would have just died in the attempt.
Read the article again. It said early on her chances were actually quite good, something like 80%
