Sue Hartigan <[EMAIL PROTECTED]> writes:
Finally a law that really makes sense. :)
Sue
Organs Must Go to Sickest First
> WASHINGTON (AP) -- Americans are dying because of an
> arbitrary system for allocating scarce organs, the
> government said Thursday. It ordered the transplant
> network to give organs to the sickest patients first,
> even if they live across the country.
>
> ``Make no bones about it, this is about living or
> dying,'' Health and Human Services Secretary Donna
> Shalala said. ``People are dying ... simply because of
> where they happen to live.''
>
> The long-expected rules represent the government's first
> set of detailed guidelines for the private contractor
> that runs the transplant network and has often clashed
> with HHS officials.
>
> Emphasizing that it is not making medical judgments,
> Shalala's agency is ordering the United Network for
> Organ Sharing to come up within five months with a new
> plan for allocating livers. The new system must give
> priority to the sickest patients rather than to those
> who live close to the donor.
>
> Network officials, who strongly oppose changes,
> responded that the HHS plan would save fewer lives,
> warning that smaller centers may close because organs
> would be diverted to large centers in other parts of the
> country.
>
> Less controversially, the rules direct the network to
> establish standard criteria for putting people on
> waiting lists and classifying medical statuses.
>
> They also order the network to release up-to-date
> information about waiting times, survival rates and
> other performance indicators for individual transplant
> programs, which the network always has refused to do.
> That should help patients make informed decisions about
> where to go for transplants, Health and Human Services
> said.
>
> The allocation system now in place offers donated organs
> first to hospitals in the local area, then regionally,
> then nationally. Patients are ranked by medical need
> within the local or regional area, but an organ is
> offered to a relatively healthy local patient before
> being sent to a sicker candidate across the country.
>
> The system has helped create widely varying waiting
> times around the country, with patients in some regions
> waiting five times as long for a transplant.
>
> The United Network for Organ Sharing argues that the
> geographic system saves more lives because healthier
> patients have better chances to survive transplant
> surgery.
>
> Yet Dr. William Pfaff, the network's president-elect and
> former head of transplant surgery at the University of
> Florida, conceded the system already favors the sickest
> patients within communities and regions. He also said
> that, given a choice between providing an organ to two
> patients in adjoining rooms, he would choose the sicker
> one.
>
> He complained that under the new system, all organs
> would go to the sickest patients, meaning patients won't
> have a realistic chance for transplant until they become
> very sick.
>
> ``Everybody deserves a chance,'' he said.
>
> The geographic system is supported by the many small
> centers that depend on a ready supply of locally donated
> organs, particularly livers. Because many more small
> centers are in operation than large ones, they have
> controlled the network's policies.
>
> Already, the network is planning lobbying campaigns in
> Congress to overturn the new plan. It has urged
> hospitals to warn their communities that the new system
> could shut down their program. Some have suggested
> fighting the rules in court, but Pfaff said he does not
> know if that will be considered.
>
> Sen. Bill Frist, R-Tenn., a transplant surgeon opposed
> to the national system concept, said Thursday he will
> hold a hearing on the new rules.
>
> Health and Human Services left open the possibility that
> it could change the rule, offering a 60-day comment
> period. Officials have already spent more than three
> years listening to various arguments.
>
> The rules are backed by large transplant programs led by
> the University of Pittsburgh, which serves sicker
> patients and would benefit from a national system.
>
> Being published next week, the rules affect all organs.
> Livers are the most controversial partly because they
> remain viable long enough to transport across the
> country. Also, a patient waiting for a liver usually
> will die without one; kidney patients, by contrast, can
> live for a long time on dialysis.
>
> The United Network for Organ Sharing has a year to
> develop the new system for organs other than livers.
> Patients on the waiting list when the rules take effect
> will not be affected by changes in the allocation
> process.
--
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1. Don't tell people everything you know.
2.
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