Monday, March 26, 2012

Death Panel of One at NBC

As most people probably know, Dick Cheney received a new heart on Saturday. And no, that's not a set up line for a joke. The procedure--a heart transplant--was performed on Saturday and Cheney is reportedly doing well. I wish him a speedy recovery and long life.

But the procedure on Cheney has--in the minds of some--re-kindled a debate: should there be age limits for transplant procedures? Cheney is 71, after all, and some think that maybe he's too old. And there has also been some suggestions that Cheney "jumped the line," maybe receiving a heart sooner than he should have because of who he is.

For the record, Cheney was on the wait-list for some twenty months. The average wait time is usually six months to a year for qualified recipients. So, there doesn't seem to be a problem. And he is not the oldest person to have received a new heart in the United States. That honor may belong to Buddy Smith of Texas, who was 75 when he received his new heart. Additionally, the age factor is not the end-all-be-all, when it comes to assessing the likely success of a heart transplant:
“Those that are 70 need to be quite healthy,” said Dr. Gregory Fontana, chairman of cardiothoracic surgery at Lenox Hill Hospital in New York. “Sometimes they do better than the younger patients.”
That’s because younger patients – those in their 20s, 30s or 40s – are often very ill and may have other medical problems that complicate their situation. Some of them even require multiple organ transplants – such as heart-kidney operations for patients with severe diabetes. 
Here’s another silver lining for the gray-maned crowd: Because older patients generally have less robust immune systems, they may require less aggressive treatment to keep their immune system from attacking the new heart, Fontana added.
But these realities haven't stopped the speculation by the punditry world. Dr. Nancy Snyderman--prodded by the always respectful and even-handed Matt Lauer--opined on the issue:

Her words:
Well, it's – people say it's unlikely that the 71-year-old jumped – jumped the line. But nonetheless, this has raised a lot of ethical questions, moral questions, about whether the Vice President, in fact, should have received his heart against – ahead of other people. And, raises the question, how old is too old to receive such a precious transplant?
It's raised "a lot" of moral and ethical questions, has it? Right. No doubt, she's said the same thing about other older patients, like Buddy Smith. What, she hasn't? Well, how can that be?

Regardless, the fundamental issue here is her last question: how old is too old to receive a transplant?

If a limit is to be imposed, who would impose it? And would people stick to it? Consider kidney transplants, every bit as vital and precious as heart transplants. Oftentimes, donors are family members who give up one kidney for the benefit of a loved one, as was the case for 84 year old Harold Wendt, who received a kidney from his 57 year old daughter in 2004. If there's an age limit, will such gifts of life become illegal? Will the organ police pounce on the removed organ and spirit it away to a more deserving younger patient?

The answer to Snyderman's last question is simple. There's nothing difficult about it, at all. No age is too old. No age is too young. And it's absolutely ludicrous to be having such a stupid debate in a nation where all are supposed to be equal before the law. But the debate, such as it is, will continue. And those who insist that they "know better" will attempt to sit in judgement on such issues, to the detriment of our liberty.

Cheers, all.

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