by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012)
The country has been gripped with interest watching the case of Sarah Murnaghan. Sarah is a 10 year old Cystic Fibrosis patient who was in desperate need of a lung transplant. The current transplant waiting list rules state that children under the age of 12 can receive lungs from an adult donor only if those lungs are not needed for an adult or adolescent in the same geographical area.
On the surface this may sound malicious and unjust, but let’s dig deeper. In order for a child, under the age of 12, to receive adult lungs they must be re-sized for the smaller chest cavity of the child. Current research says that this re-sizing process can make the lungs less stable and the transplant less successful than adolescent or adult transplants.
Being a logical thinker these types of media frenzy stories drive me batty. An uneducated public is led by a manipulative or possibly, equally uneducated media to “react” on emotion rather than truly think about the issue. In a moment the country was abuzz about the “unfair” transplant allocation rules and how we need to change them RIGHT NOW!
I am not saying that these rules don’t need to be updated; I am certainly no authority on lung allocation or transplantation. My knowledge in this area is limited to information that came up in my recent Google search. We may very well need to change the process, but let’s take our time, use logic, and consult the experts.
Certainly, Sarah’s story is heart wrenching and no one wants to see a little girl’s life end. Medical policy however, cannot be created based on preventing whichever outcome would make us the most sad. UNOS, the United Network for Organ Sharing, has difficult, almost impossible decisions to make every day about who receives the organs they have available. They have to make these decisions logically and free of emotion. To be truly just, they need to give the organs to patients who will benefit from them the most, this includes considering which transplants will be the most successful.
After the nationwide outcry and a court order, Sarah’s name was given priority on the lung transplant list. She received her transplant and her body almost immediately rejected the lungs. Three days later Sarah received a second transplant; it is extremely rare to receive two transplants so close together. This second surgery was approximately two weeks ago, and according to press releases from her parents Sarah is doing well.
We should certainly all be happy for Sarah and her family and pray for her continued recovery. I have no issue at all with the Murnaghan’s fight for their daughter. I understand what it means to have a family member with a terminal illness and the need to exhaust every resource within reach to save them. Any avenue that brings a family peace or allows them to continue the fight is fine with me.
I am disappointed however with the reactive media and general public. Organ allocation is a complex process and should be treated as such. This means any proposed changes should be thoughtful, logical, and well supported with data. Sarah’s story stirs emotions in us and we want to help her, but what about the other people on the transplant list?
Maybe there is a 15 year old honors student, or a 22 year old with aspirations for medical school, or a 25 year old mother of 2, or 40 year old father of 5. We need to keep in mind that Sarah’s is the story we know, but not the only sad story on the lung transplant waiting list. We trust UNOS with the decisions, because they have a commitment to making them logically, based on need and benefit rather than emotion.
[This blog entry was originally posted in a slightly edited form on Ms. Spranger’s blog on June 30, 2013. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]