Waste of a perfectly good heart

[coloradoatheist]

Unfortunately we can only make an educated guess. Somebody with medical knowledge would need to know the heart type he needed, blood type, etc and how many people on the waiting list were looking for that type of heart.

Well, ok but until then compassionate people must vehemently deny that additional organs save lives.

I agree with you, but in this case it's something specific.

 

[laughing dog]

Unfortunately we can only make an educated guess. Somebody with medical knowledge would need to know the heart type he needed, blood type, etc and how many people on the waiting list were looking for that type of heart.

Well, ok but until then compassionate people must vehemently deny that additional organs save lives.

Additional organs would increase the number and probably the diversity of the available organ pool. In all likelihood, that would mean more people would get the needed organs more quickly. In turn, that improves the quality of their lives and probably increases their life expectancy. In addition, it would reduce the resources needed to keep people on waiting lists alive, thereby freeing up those resources for other uses, including medical ones.

 

[Axulus]

We are told to stop inserting politics into science and to let climate scientists and evolutionary biology teachers do their jobs. Yet the left seems a-ok with inserting politics into the medical profession when it comes to a decision necessitating medical expertise and not letting them do their jobs.

 

[GenesisNemesis]

What do bad grades have to do with receiving a heart transplant? I understand how the other things would, but it seems outlandish to mention bad grades.

 

[Axulus]

What do bad grades have to do with receiving a heart transplant? I understand how the other things would, but it seems outlandish to mention bad grades.

As was mentioned previously, it is one criteria among many (not the sole deciding criteria) that correlates with non-compliance of post op treatment. The more important criteria was a history of ignoring doctors' instructions in this particular case.

 

[laughing dog]

We are told to stop inserting politics into science and to let climate scientists and evolutionary biology teachers do their jobs. Yet the left seems a-ok with inserting politics into the medical profession when it comes to a decision necessitating medical expertise and not letting them do their jobs.

Deciding who gets to live and who gets to die or who gets to have his/her life expectancy is more than simply a medical decision.

 

[coloradoatheist]

We are told to stop inserting politics into science and to let climate scientists and evolutionary biology teachers do their jobs. Yet the left seems a-ok with inserting politics into the medical profession when it comes to a decision necessitating medical expertise and not letting them do their jobs.

Deciding who gets to live and who gets to die or who gets to have his/her life expectancy is more than simply a medical decision.

Wasn't that the argument critics of Obama Care said would happen, government would decide life and death?

 

[laughing dog]

Deciding who gets to live and who gets to die or who gets to have his/her life expectancy is more than simply a medical decision.

Wasn't that the argument critics of Obama Care said would happen, government would decide life and death?

The critics made that argument based on the fiction of "death panels".

 

[coloradoatheist]

Wasn't that the argument critics of Obama Care said would happen, government would decide life and death?

The critics made that argument based on the fiction of "death panels".

The argument was that the IPAB would ration health care, leading to the government deciding life and death situations.

 

[AthenaAwakened]

We are told to stop inserting politics into science and to let climate scientists and evolutionary biology teachers do their jobs. Yet the left seems a-ok with inserting politics into the medical profession when it comes to a decision necessitating medical expertise and not letting them do their jobs.

If you think this about left and right, then you don't get it.

 

[RavenSky]

What do bad grades have to do with receiving a heart transplant? I understand how the other things would, but it seems outlandish to mention bad grades.

I seriously doubt the doctors specifically stated "bad grades", I suspect that was the media's sound-bite version because it sounds more outrageous. What is an indicator, however, is his young age and education level.

Researchers have explored three categories of variables that appear to be associated with noncompliance. These categories include demographic characteristics, psychological variables, and social variables. There are a variety of studies that provide convincing evidence that noncompliance and related demographic, psychological, and social variables post-transplant are relatively frequent and often predictable.

Demographic predictors associated with noncompliance include young age at transplant[11,12] and lower educational level.[12-15] In a retrospective study[12] of 374 adult renal transplant patients, the investigators found the pattern of a typical noncompliant patient included an age of approximately 38 years or less and an educational level of approximately 13 years or less. Likewise, Shapiro and coworkers[15] in a prospective study of 125 heart transplant patients found that an educational level of approximately 13 years or less was a potential risk factor for coronary artery disease of the transplanted heart. In contrast, in a retrospective study of 53 heart transplant recipients, Paris and associates[16] found that those recipients with an educational level of more than 13 years were less likely to develop noncompliance. In addition, Grady et al.[10] found in a prospective study of 120 heart transplant recipients that those recipients who were 53 years or older were more likely to attend clinic visits and have tests completed at 1 year and 2 years after transplant.

http://www.medscape.com/viewarticle/459038_2

Earlier, I also speculated that whatever "brushes with the law" he'd had might have also been considered in light of the following:

Psychological predictors of noncompliance include patient reports of depression, anxiety, anger-hostility, and substance abuse.

Recipients with high levels of anger-hostility were 13 times more likely to be noncompliant than those without anger-hostility. Dew and colleagues[8] confirmed their findings in a 3-year longitudinal study where high levels of depression, anxiety, and anger-hostility post-transplant were found to be predictive of noncompliance in the long-term management of the transplant recipient.

I don't know what his actual history was, but given his later crimes it is plausible that he exhibited a degree of "anger-hostility" that the doctors noted as a predictor of non-compliance.

The media may have then taken that as the kid was denied a heart just because he'd made a few bad choices in his younger years. Derec, on the other hand, seems to have taken that as something like "thugs shouldn't get hearts". Neither of these are accurate.

 

[laughing dog]

The critics made that argument based on the fiction of "death panels".

The argument was that the IPAB would ration health care, leading to the government deciding life and death situations.

Health care is always "rationed" in some fashion, since it is not limitless. So the critics' argument had little merit on its face.

 

[coloradoatheist]

The argument was that the IPAB would ration health care, leading to the government deciding life and death situations.

Health care is always "rationed" in some fashion, since it is not limitless. So the critics' argument had little merit on its face.

But the argument was who would make the rationing decision. In Obamacare it would be IPAB and people argued it should be the doctors, in this case the doctors rationed the care and then public opinion stepped in. But I'm not sure in this case if the doctors caved to pressure or if it was the hospital or another organization.

 

[laughing dog]

Health care is always "rationed" in some fashion, since it is not limitless. So the critics' argument had little merit on its face.

But the argument was who would make the rationing decision. In Obamacare it would be IPAB and people argued it should be the doctors, in this case the doctors rationed the care and then public opinion stepped in.

Actually, the critics really wanted money (i.e. access to medical care) to make the rationing decision. Which means it was more than a medical decision.

 

[coloradoatheist]

But the argument was who would make the rationing decision. In Obamacare it would be IPAB and people argued it should be the doctors, in this case the doctors rationed the care and then public opinion stepped in.

Actually, the critics really wanted money (i.e. access to medical care) to make the rationing decision. Which means it was more than a medical decision.

There were three camps. Ratio health care based on what somebody or insurance wants to pay, government rationing, or doctors rationing. Axulus was arguing against people who wanted doctors there and now public opinion on this case.

 

[RavenSky]

Actually, the critics really wanted money (i.e. access to medical care) to make the rationing decision. Which means it was more than a medical decision.

There were three camps. Ratio health care based on what somebody or insurance wants to pay, government rationing, or doctors rationing. Axulus was arguing against people who wanted doctors there and now public opinion on this case.

Axulus is arguing against a strawman.

 

[Loren Pechtel]

No, it means you don't understand the math involved....

I understand. You don't have any data or evidence, so you literally make stuff up to justify your assumptions about reality.

If I made a math error point it out. Otherwise, concede.

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No, it means you don't understand the math involved.

We have organ A. The demand is 1000/yr. The supply is 10/yr. 1% die of other causes, 980/yr die from the lack of an organ.

Organ B has a better supply. The demand is still 1000/yr but the supply is 500/yr. You still have 1% other deaths, now 490/yr die of the lack of an organ.

Note that the supply changed by 490/yr and the deaths also changed by 490/yr. It's 1:1 even though we dropped from 98% to 49%. In other words, the percentage doesn't matter.

(In practice there is the risk of the operation that will change this a bit. The basic pattern is still there, though.)

Dude, you're getting a bill from the Emergency Room for the cost of getting my brain unknoted. It has been a while since I've seen so many numbers mean just about nothing and trying to make sense of it made my brain tie itself in knots.

Try actually looking at the situation. What's wrong with my analysis other than it tells you something you don't want to hear?

- - - Updated - - -

Yes, we are making such an assumption--because it's reality. They can fly them to other cities, the pool of recipients is large. It might not be someone at the top of the list but there will be someone.

It's not reality. The absolute truth---and I have personal knowledge, is that geography matters. There is only a very short time period in which to harvest organs, perform all of the testing, which is not just genetic testing but also includes screening for a variety of diseases which can be transmitted by transplant and/or blood donation and transporting the organs to wherever the donor is. Sometimes there is a bigger cushion of time: the donor whose family has agreed to the donation is brain dead but the body can be kept alive while testing is being performed and the best match can be found and transportation is arranged. This is the case with hearts as at this time, only 'beating hearts' are transplanted. The time frame here is still short-- hours and not days. Not every hospital is equipped and appropriately licensed to perform the appropriate testing--a brain dead person may not be at a hospital where the appropriate testing can be performed so blood samples must be collected and transported to an appropriate testing facility. These facilities are very tightly regulated. Not ever potential recipient is within the geographic distance that can be managed within the time frame.

Throw in that families can hold up the process as they come to grips with the death of their much loved family member and sometimes will challenge the donation, even if the donor has signed a card. This all takes very valuable time. It is extremely generous of families to be able to come to grips with all of the issues and agree to the donation at such a very vulnerable time, in a very short time frame.

Matches also need to be not just for tissue type but also size. A child requiring a transplant needs a small organ. A large adult requires a larger heart, not one from a child.

It's not as simple as we'd like to think.

You're talking about organs that are unavailable because the person dies in a facility not equipped to handle it. Those aren't useable organs in the first place.

 

[laughing dog]

I understand. You don't have any data or evidence, so you literally make stuff up to justify your assumptions about reality.

If I made a math error point it out. Otherwise, concede.

There is nothing for me to concede: your example has no basis in empirical fact. It is yet another example of you confusing the results of the neurons firing in your head with actual reality. The reality is that 7% of the people waiting for a transplant die while on the list. That means it is unlikely that this particular heart transplantation meant someone else died while waiting to get a similar heart.

 

[Loren Pechtel]

If I made a math error point it out. Otherwise, concede.

There is nothing for me to concede: your example has no basis in empirical fact. It is yet another example of you confusing the results of the neurons firing in your head with actual reality. The reality is that 7% of the people waiting for a transplant die while on the list. That means it is unlikely that this particular heart transplantation meant someone else died while waiting to get a similar heart.

If you think there's some logic to your conclusion model what happens as you change the number of organs.

 

[laughing dog]

There is nothing for me to concede: your example has no basis in empirical fact. It is yet another example of you confusing the results of the neurons firing in your head with actual reality. The reality is that 7% of the people waiting for a transplant die while on the list. That means it is unlikely that this particular heart transplantation meant someone else died while waiting to get a similar heart.

If you think there's some logic to your conclusion model what happens as you change the number of organs.

You are the one who is claiming that this transplant cost someone on the waiting list to die. Up to this point, you have failed to do so. Instead of shifting the goal posts , make an argument that is rooted in reality, not some concocted mumbo-jumbo.