Ranting On...the Unfortunate Precedent of Sarah Murnaghan

Over the past few weeks, we've all come to know the unfortunate situation of Sarah Murnaghan.  A 10-year-old girl with weeks to live, she was in vital need of a lung transplant, but was unable to get one due to the so-called "Under 12" rule, which stipulated that children under the age of twelve would only be eligible for lung transplants from other children, rather than from adults.  The reasons behind the rule seem to have be that an adult transplant would not be as likely to be successful with a younger child, and that a child may not respond as well to the transplant as an adult or an older child would.

The flip side of this is that it is exceedingly rare for a healthy child's lung to become available, and so those that are on the list could be on the list for years (as is the case for Sarah Murnaghan) and as is the case across the organ donation system, there are instances where a patient could die waiting.

This rant isn't about how tragic it is that a young girl is put into such a horrible situation (we all know it's tragic), nor it is about how it may be appropriate for the medical community and the Department of HHS to revisit their policies on the criteria for eligible organs for donation or for them to increase awareness about organ donation and to debunk preconceived notions about organ donation (you know the one I'm talking about-the urban legend that people may not get life-saving medical attention because the doctor wants their organ for another patient).  These are both topics worth discussing, but I don't have a medical degree and I can't make an informed argument for or against said practices.

What I can make an argument for, and what this rant is about, is the dangerous precedence that has been set forward by Ms. Murnaghan's case.  Were it not for Ms. Murnaghan's going to both her member of Congress (Rep. Lou Barletta) and getting a restraining order from Judge Michael Blayson against the Deparment of Health and Human Services, it's difficult to see that she would have received the lung transplant yesterday.

On the surface, a little girl getting a chance to live is a good thing, of course, and I want to be very clear that like every person in the country who has paid attention to this case, I want the transplant to be successful (and since this should be obvious to any sane person who doesn't want to get into a trolling flame war, that's the last time I'm going to point it out, as tempers on this issue have gotten pretty high).

The problem is, though, that Sarah Murnaghan got her transplant by circumventing a system that not everyone can circumvent, taking fairness and impartiality out of the equation.  Not everyone in the country has the means to be able to get their congressman to act and to challenge this issue in the courts.  The system is set up so that this shouldn't happen, and that the organs are donated to the person who is most in need AND who is going to be the most successful recipient of the lung.  Sarah Murnaghan's adult lung donation is statistically less likely to be successful than if the lung were transplanted into another adult and a child.  Ms. Murnaghan is only receiving this because her parents had the means and the financial ability to challenge this in court.

As a result of her success, it is likely that other families and patients will attempt to gain similar restraining orders to gain vital organs for their children's survival, thus taking impartiality out of the process and circumventing the transplant list in favor of those who have the most money and shout the loudest.  We already have far too much of our medical decisions in this country decided by a person's financial status.  You hear it everytime someone discusses health care policy, but senior citizens who have to decide between food and medicine in this country really do exist.  People die every year because they cannot afford a vital surgery or procedure in this country.  It is a travesty that in one of the most powerful and forward-thinking countries in history, whether out of greed or ignorance or bigotry or political calculation lets people die because they cannot afford the medical care necessary to stay alive.  No one should have to go bankrupt in order to live, and the sooner we as Americans decide that every life is precious and endorse a universal healthcare system, the better.

But that's a tangent (a sound one and one valid to this conversation, but a tangent nonetheless and I will get back on track).  So I should get to the obvious reason that this circumvention of the legal process is dangerous and a horrible misuse of the transplant system; because Sarah Murnaghan got this transplant, it is almost certain that someone else will die as a result.

No one wants to seem to say this outloud, least of all the media which has taken up the cause of this little girl, but it's nearly certain to be the truth.  There are not a surplus of lungs in the country (otherwise we wouldn't have transplant lists), and those that are on them are likely in vital need of these organs to live.  The media has spent a good deal of time focusing on how the system has cheated Sarah Murnaghan, but the reality is that Rep. Barletta and Judge Blayson have now cheated someone else who was waiting for that lung, and at some point down the line, this transplant, which was given by going around the proper, legal system is going to cause someone who would have received a transplant to die.  This is a zero-sum situation-because Sarah Murnaghan gets the transplant, someone else who was legally entitled to the lung wiill almost certainly die.

It's difficult the recuse the Murnaghan parents from this comdemnation.  Not only have they suffered quite a bit, but they did what they needed to do to give their daughter a chance.  Every parent would do the same thing in the same situation given the means that the Murnaghans had at their disposal.  However, it is impossible to recuse or forgive Rep. Barletta and in particula Judge Blayson in the same circumstance.  As a member of Congress and as a member of the judiciary, they are not supposed to be swayed by emotional tales.  They are supposed to do what they are legally required to do-in Rep. Barletta's case, try to change the law through his role in Congress for all people and not just the few, and in Judge Blayson's case, to uphold the law and the regulations of the medical boards responsible for organ transplants.  That they didn't, that they instead preyed upon the media, and in the case of Rep. Barletta, launched an assault on the moral character on Sec. Kathleen Sebelius, who was simply upholding the law as she should, is a travesty of justice for that person who will not receive the lung transplant they desperately need for survival.

And though it doesn't really need to be said, Sarah Palin and her "Obamacare" references are such dangerous political lies that I have to point out that this law, which on the face of itself seems like a fairly just law, was not a part of Obamacare at all, but instead a law passed under the Bush administration.  Once again, Ms. Palin proves that she cares little for the facts or for the welfare of her fellow Americans, and only about bashing her former opponent.

And therein lies the third culprit that should share a bulk of the blame with Judge Blayson and Rep. Barletta-the media.  The media, sensing a story that they could sell rather easily, jumped on the bandwagon, demonizing Sebelius as uncaring and ignoring the law and the facts.  Selling only side of a story and not giving the zero-sum facts of the case is a horrible misuse of the media.  If you want an example of why people continue to have an overwhelming distrust with journalists, it's because they give us such one-sided stories.

That's pretty much all I have to say about this decision.  It is difficult to see this sort of circumvention of the law not occurring with regularity in the next few months, and in turn, adding another element where money and power infiltrate the should-be unbiased field of medicine.  But it's a shame that we aren't spending time targeting the real issues in this debate (increasing organ donation, funding more advanced medical research so that transplants are unnecessary), rather than sensationalizing an unfortunate situation and causing dozens more in the process.