CASE TITLE: Allocation of Medical Resources

Bioethics for clinicians: 13. Resource allocation

url's for Articles with Ethical Position: Philosophers, Theologians, Lawyers, Medical Doctors

A Buddhist point of view

"Social Worth" in the Allocation of Scarce Resources

THE ETHICS OF HEALTH CARE ALLOCATION

Name: Jon Shobin

Case Title: Mickey Mantle Liver Transplant

Description: Baseball Hall of Fame Yankees slugger Mickey Mantle died in 1995 two months after receiving a liver transplant. Mantle was a famed carouser who finally admitted to alcoholism in the 1990s. After attending the Betty Ford Clinic for alcoholism rehab in 1993, he was diagnosed with liver failure in 1994 and received a transplant in 1995. Liver cancer was discovered at the time of his transplant, and he died two months later. Numerous questions remain about whether he received preferrential treatment.

URLs about the case:

1. www.washingtonpost.com -- 1995 article about the sports hero's life, death, and liver transplant.

2. www.sportsillustrated.cnn.com/almanac -- 8-13-95 story, "Hall of Fame Slugger Mickey Mantle Dies," reports his death from alcoholism and liver cancer after transplant.

3. www.dailyillini.com/Feb_99 -- "Payton's Case Puts Spotlight on Organ Donation" -- Walter Payton, football great, discusses his own problems with liver transplantation in light of Mantle's apparent ease in getting a liver.

4. www.transweb.org -- An article defending Mantle's receipt of a liver, as he was "the most needy that day in that region under the UNOS (United Network of Organ Sharing) guidelines."

URLs with ethical viewpoints:

1. www.oup-usa.org -- A review of the book "Raising the Dead: Organ Transplantation Ethics and Society," by Ronald Munson -- Discusses Mantle's controversial liver transplant and analysis of surrounding ethical questions.

2. www.news.harvard.edu/gazette/1996 -- Article by Melissa Roche: "SPH Program asks Tough Questions About Health Care Costs." reviews the ethical debate about whether Mantle was moved to the top of the list because of his celebrity status.

3. www.info.med.yale.edu/11/Disciplines/Disease/Transplant/Ethics -- Three essays from Yale discuss presumed consent, financial incentives for donation, and preferred status, with reference to Mantle.

4. www.mcn.org/c/irapilgrim/edu23.html -- A 1995 article entitled "Heroes" -- an article about misplaced heroics, with references to Mantle and his transplant.

Patricia Reale

Case Description: Organ_Allocation

Mickey Mantle was an alcoholic for many years and developed cirrhosis of the liver. He only waited a short time for a liver transplant and some believe it was because of his financial and social status. It caused a lot of debate in the media.

url?s describing case:

http://www.gmu.edu/departments/economics/wew/articles/95/Organs.htm

http://www.gmu.edu/departments/economics/wew/articles/98/donate-ro-sell.htm

http://www.ama-assn.org/sci-pubs/msjama/articles/vol_282/no_17/jms90035.htm

http://www.cato.org/pubs/journal/cj17n2-3.html

url?s describing viewpoints: http://www.westmont.edu/departments/biology/journals/wjneuroscience/Volume3/garone.html

http://www.csu.edu.au/learning/eubios/NBBOT.html

http://www.lahey.org/ethics/newsletter/fall2000_html.stm

http://www.unomaha.edu/~wwwpa/project/huffman.html

Name: Anne Green

Case: Mickey Mantle’s controversial liver transplant – do famous people get transplants quicker?

Description: Baseball great Mickey Mantle was diagnosed with end-stage liver disease in 1995, after living the last 43 years as an alcoholic. He was immediately placed on the United National Organ Sharing (UNOS) waiting list, and a person in 1995 would have to wait approximately 142 days for a matching donor. There was a match found in less than two days, which sparked public outcry. Other famous people (e.g. singer David Crosby and actor Larry Hagman) who were on a liver transplant waiting list (and also alcohol and drug abusers) received donor matches within approximately 2-3 weeks. The UNOS recently changed its policy stating that people suffering from chronic liver disease brought on by alcohol and drugs would be bumped to the bottom of the list in order to help those people who would benefit the most from the transplant.

Information:

http://www.lubbockonline.com/news/111596/chronic.htm

http://www.csuchico.edu/engl/faculty/engl1Tom/Mickey%20Mantle.html

http://www.eonline.com/News/Items/0,1,742,00.html

Dr. Jeff Punch, Transplant Surgery, University of Michigan, says "no":

http://home.earthlink.net/~russlover/connected.html

Religious, Medical, Legal, Philosophical Commentary:

The Cato Journal (Libertarian comment):

http://www.cato.org/pubs/journal/cj17n2-3.html

Harvard University Gazette (School of Public Health):

http://www.news.harvard.edu/gazette/1996/04.25/SPHProgramAskst.html

Journal of Hepatology (Is liver transplantation an appropriate treatment for acute

alcoholic hepatitis?)

http://www.elsevier.com/gej-ng/10/26/38/76/57/44/article.pdf

AMA News – Liver transplant allocation scoring system:

http://www.ama-assn.org/sci-pubs/amnews/pick_02/hll20513.htm

Hepatitis Magazine – Transplant Ethics:

http://www.hepatitismag.com/features/default.asp?HepStoryID=2