Someone lives and someone dies

[TGHusker]

http://washingtonexa...article/2531097

 

 

Ok, facts in the article:

1. Girl, age 10, needs lung transplant. - has 4-5 wks to live

2. Federal law since 2005 says you have to be 12 to receive an adult lung - no youth lungs available

3. Representative pleads that Sec Kathleen Sebelius over rule the age requirement (she is the only one who can authorize this)

4. She declines - stating: “I would suggest, sir, that, again, this is an incredibly agonizing situation where someone lives and someone dies,”

5. There is a waiting list for adult lungs.

6. The girl's doc says she can survive wt the adult lung.

 

Discussion:

1. Did Sebelius make the right decision? Why or why not?

2. Is this a foretaste of what healthcare in the form of ACA will look like - decisions made by panels in DC?

3. Should decisions like this always be this cut and dry (govern by regulations)?

 

 

My take:

1. Yes, as unfeeling as it sounds, she probably made the right decision based on the facts as presented in the article.

2. I don't know. I haven't studied this. There are those who say there are "death panels" in ACA and those who say there aren't. I just have not had the time to read much about it. Maybe Carl or others who have studied it more can enlighten me. i did find this article on a quick google look up that pretty much disputes the concept of death panels:

http://www.forbes.co...ath-panel-myth/

 

3. I hope not. I hope their is more room for patient/doctor decisions. However, a transplant goes far beyond the patient and doc. It involves many other individuals needing the same transplant and thus has to be regulated and govern externally. I would like to see more flexibility. A 10 year old with a full life ahead of her, if she receives a lung, could be an 'exception to the rule' that I would hope more than one person (Sebelius) could evaluate.

[knapplc]

Death Panels are bad.

 

But let's appeal to the Health Secretary to make a life-and-death decision regarding medical care.

 

Huh?

[TGHusker]

Death Panels are bad.

 

But let's appeal to the Health Secretary to make a life-and-death decision regarding medical care.

 

Huh?

That was my main concern - that only the top person can make that decision - instead of a group of medical professionals. I was actually surprised by that in the article - I didn't know a non-medical administrator had that authority. She may have made the right decision as I note in the OP but I'd prefer it be made by a group of medial professionals.

[StPaulHusker]

Based on what little information there was on this article, it's really difficult to say what was right or wrong. I will tell you that her comments about the young girl "someone lives, someone dies" was insensitive and she should be ashamed of herself.

 

I would hardly call it a death panel. Transplant doctors set this standard in 2005. We would need to know why before making a conclusion. Also, the doctors THINK that she will live using an adult lung. With 40 other people waiting for lungs, I can see the firestorm it could cause if it failed.

 

Without knowing what other information Sebelius had to make this decision, I think she made the right one although I think her comments could have been a little more sympathetic to the discussion

[StPaulHusker]

Death Panels are bad.

 

But let's appeal to the Health Secretary to make a life-and-death decision regarding medical care.

 

Huh?

That was my main concern - that only the top person can make that decision - instead of a group of medical professionals. I was actually surprised by that in the article - I didn't know a non-medical administrator had that authority. She may have made the right decision as I note in the OP but I'd prefer it be made by a group of medial professionals.

That's not entirely accurate based on the article. She has the authority to suspend the policy for review. It was a group of transplant doctors that made the decision of what age could get an adult lung.

[rawhide]

Yes, many factors to consider.

 

1. Age composition of the adult waiting list

2. Prognosis of the adult waiting list

3. Other medical factors considered in morbidity rating of adult list

 

just a couple of things I would hope be considered;

[Someone]

 

Discussion:

1. Did Sebelius make the right decision? Why or why not?

2. Is this a foretaste of what healthcare in the form of ACA will look like - decisions made by panels in DC?

3. Should decisions like this always be this cut and dry (govern by regulations)?

 

 

My take:

1. Yes, as unfeeling as it sounds, she probably made the right decision based on the facts as presented in the article.

2. I don't know. I haven't studied this. There are those who say there are "death panels" in ACA and those who say there aren't. I just have not had the time to read much about it. Maybe Carl or others who have studied it more can enlighten me. i did find this article on a quick google look up that pretty much disputes the concept of death panels:

http://www.forbes.co...ath-panel-myth/

 

3. I hope not. I hope their is more room for patient/doctor decisions. However, a transplant goes far beyond the patient and doc. It involves many other individuals needing the same transplant and thus has to be regulated and govern externally. My would like to see more flexibility. A 10 year old with a full life ahead of her, if she receives a lung, could be an 'exception to the rule' that I would hope more than one person (Sebelius) could evaluate.

1. Federal Law. If you don't like it, appeal to congress, not Sec of HHS.

2. There are those that say the earth is flat. Just because they say it and the tin foil hat army repeat it doesn't make it true. This has NOTHING to do with ACA. It's a 2005 law, based on your post.

3. I got 4 organs and 239 people on the waiting list. Who should write the policy as to how transplant organs are allocated? Should we follow the policy? Is a 10 year old more worthy of saving than a 23 year old or a 43 year old?

[Mavric]

Yes, many factors to consider.

 

1. Age composition of the adult waiting list

2. Prognosis of the adult waiting list

3. Other medical factors considered in morbidity rating of adult list

 

just a couple of things I would hope be considered;

From what I understand, none of these are considered. If you're under 12, you have to wait until all adults are off the list before you get a chance.

[BigRedBuster]

Yes, many factors to consider.

 

1. Age composition of the adult waiting list

2. Prognosis of the adult waiting list

3. Other medical factors considered in morbidity rating of adult list

 

just a couple of things I would hope be considered;

From what I understand, none of these are considered. If you're under 12, you have to wait until all adults are off the list before you get a chance.

 

 

 

I would be interested in the rational behind this. Obviously there is something there. But, just with this information, it doesn't make sense to me.

[carlfense]

I'm a little confused as to why this poor little girl with cystic fibrosis should jump to the front of the transplant line? Even if the adult/child distinction were waived in this case (which may or may not even be legal, depending on who you ask) she would be behind about 40 other patients awaiting a donor.

 

Death panels? No. Just no.

 

What decision did Sebelius make? It saddens me that this is the state of our politics.

[carlfense]

From what I understand, none of these are considered. If you're under 12, you have to wait until all adults are off the list before you get a chance.

That's incorrect.

[carlfense]

Death Panels are bad.

 

But let's appeal to the Health Secretary to make a life-and-death decision regarding medical care.

 

Huh?

It's an interesting change in tactics.

[StPaulHusker]

I'm a little confused as to why this poor little girl with cystic fibrosis should jump to the front of the transplant line? Even if the adult/child distinction were waived in this case (which may or may not even be legal, depending on who you ask) she would be behind about 40 other patients awaiting a donor.

 

Death panels? No. Just no.

 

What decision did Sebelius make? It saddens me that this is the state of our politics.

She decided against suspending the rules of the policy on the age of somebody receiving an adult lung transplant.

[carlfense]

She decided against suspending the rules of the policy on the age of somebody receiving an adult lung transplant.

And who said that she had the power to suspend the rules?

[BigRedBuster]

I'm a little confused as to why this poor little girl with cystic fibrosis should jump to the front of the transplant line? Even if the adult/child distinction were waived in this case (which may or may not even be legal, depending on who you ask) she would be behind about 40 other patients awaiting a donor.

 

Death panels? No. Just no.

 

What decision did Sebelius make? It saddens me that this is the state of our politics.

 

 

From what I remember from when I was working in health care with transplant patients, there were two main factors on who got organs.

 

a) Seniority on the list.

b) Condition of the patient.

 

Not sure if any of that has changed. I have absolutely no clue as to this case. But, if she was behind 40 people because of seniority but her condition become a lot worse than theirs then she could be bumped ahead of them.