Poll: Should recovered alcoholics be given liver transplants on the NHS?

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Treblaine

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Belladonnah said:
You get hepatitis for a simple one time mistake. You probably abused alcohol for years to get severe liver damage. Yes, I think patients should be punished for being directly responsible for their damaged organs. I don't mean being prevented from ever getting a transplant, just being a lower priority to someone that needs a liver because of more natural causes.
Hmm? ONE simple mistake?

You know most people catch STD's from patterns of risky behaviour. Unprotected sex with any one person has a low chance of catching an infection, even if they are a carrier. No, it wouldn't even be "just one mistake" it would be doing the same mistake over and over again till you "strike-unlucky".

It's like paying Russian Roulette and the hammer falls on an empty cylinder, just because you didn't blow your brains out in that particular round doesn't mean it wasn't an incredibly dangerous thing to do.

"Yes, I think patients should be punished for being directly responsible for their damaged organs."

You aren't living in the real world mate, you're living in cloud fucking cookoo land. have you ever worked in a hospital, I've had some intern-ship there in preparation for a career in radiography and most of the people there are "directly responsible for damage to their organs"

So if you break your arm by accident and go into A&E department, please be prepared to wait a few days as "punishment" because it's not like the PAIN AND DISABILITY ALONE are punishment enough. No. We're going to make you wait while far less needy people go ahead of you.

Due to the very nature of addiction people cannot think rationally, they can't appreciate the damage they are doing. The damage to their liver is no different from DIY or sporting injuries... they are accidents. Prolonged onset, but no significant distinction.
 

cuddly_tomato

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Why isn't this exactly the same as asking "Should we give fat people heart operations?" or "Should we give scuba divers treatment for decompression sickness?"

What the hell people. The NHS is there in order to treat people who fall sick, not to tell them to bugger off when they need the service most.
 

Frequen-Z

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generic gamer said:
You know, that's actually pretty convincing and I don't have any real counter-points to it. You also could have made that post a lot more hostile, which I thank you for not doing, I was in a bit of a moody swing when I wrote that post so cheers for not rising to it.

I think there needs to be a point where a person shouldn't receive treatment (eg. If someone has wrecked 2 or maybe even 3 livers if that's possible) but drawing that line is extremely immoral by anyone's books and it would be astonishingly hard to do correctly.
 

moretimethansense

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King of the Sandbox said:
KnowYourOnion said:
Put them on the list but don't give them a high priority
This way they still get a liver but the more urgent cases are treated first
This sounds like the only truly humane option. I'd go with that.
I third this.

on one hand recovered alcoholics may relapse but on the other (almost) everyone deserves a second chance and sometimes people that get sober stay sober.
 

AmayaOnnaOtaku

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As for the drugs being a pharmacy tech I saw patients on them and continued to drink, they had been able to overcome the side effects.
 

ThaBenMan

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Well, my mother just died about two months ago from liver failure, so of course I wish that she would have been able to get a liver transplant. But on the other hand, I definitely understand the reasoning that non-alcoholic people should be the priority, and she very well may have relapsed afterward. So, I'm not sure...
 

Treblaine

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GodKlown said:
I say no. You chose your actions, and you knew the risks of your actions. People don't want to seem to pay the consequences for their actions anymore, they just want to do whatever the hell they like and expect someone else to fix it for them. I'm not saying that they are undeserving of treatment, but there are a lot more people in serious need of those livers who did nothing to complicate their situations by bad decisions.
I have a strong dislike of alcoholics for personal reasons, but I'm not going to sit here and say that all people who drink to excess deserve liver failure and to die a painful death. Anything done to excess is bad. Sure, I eat and smoke and I know in the future what the consequences might be if I don't take more responsibility for what I am doing now, but who the hell in their right mind even thinks about that?
You know that is NOT how liver transplants work, its not like they are NOT infinitely divisible and can just "sew them into anybody, they'll work just as well".

No. You get a liver (from a Donor who died in a state where their organs can be stabilised) and you match up the cell receptors. A perfect match is unlikely, but you want as many surface receptors to match as possible as the more matches = less immune-suppressant drugs needed.

usually, this results in only a single individual within an area the organ can be promptly transported to being the best match. There are adjustments made according to need, such as if someone is on the brink of death or another can wait another month, but it comes down to one person.

But if that one person happens to be an ex-alcoholic would you burst into the ethics meeting and say: "Fuck That! Put the Liver in the person that is a worse match - and is most likely to be rejected - because the alkie *deserves* to suffer because they *brought this on themself*"


Seems like in the United States, the government is doing nearly all they can to make cigarettes as borderline illegal as they can. By the end of this month, they are prohibiting the postal service from shipping them anymore, and a lot of states do not allow people to smoke indoors, unless they own their own house. You can't smoke in bars, at work, closer than 100 feet of the doors at work, in company cars, all hotel rooms, rental cars, and I've even seen some outdoor concerts that don't allow smoking.
No, that' just common courtesy because cigarette's stink up the place, so everyone, private business included prohibit indoor smoking. It was tolerated in like the 1950's when EVERYONE smoked (probably because there wasn't anything better to do) but most people don't smoke any more probably because it went out of fashion.
Regardless of the law, if you are going to create large volumes of smoke, go outside to do it.


But drinking apparently doesn't suffer the same restrictions, I suppose because they can argue that being drunk doesn't affect the person sitting next to you... unless you happen to throw up on them or kill them in a car accident driving home. Why alcohol in general doesn't suffer the same stigmas as cigarettes and isn't listed in drug schedule is beyond me at this point. Alcohol has no health benefits and is addictive and ruins people's lives, yet it is as legal as water, so long as you are of a certain age in this country. I'm not exactly saying that this world should mirror the one shown in the movie Demolition Man, but I think there needs to be more stricter rules for alcohol like they have for cigarettes. There are certain benefits from red wine and whatnot, but they have compressed those benefits into a pill form, so it eliminates the need to get drunk if you claim you are only doing it for the healthy aspect.
"yet it is as legal as water, so long as you are of a certain age in this country."

yeah, Twenty One. America has some of the strictest alcohol laws of the western world.

Have you considered moving to Saudi Arabia or Oman? They may treat booze with the appropriate over-reaction over there.

Hard drug addicts should fall into the same category as alcoholics when it comes to any kind of organ transplants because they chose their fate when they sat around for years shooting heroin between their toes. You knew every single time you stuck a needle in you or poured yourself another drink that you were doing harm to your body, but when those ramifications start to actually affect you, that's when you begin to worry.
Except that cause-and-effect of damage is highly disconnected, there is no certainty. The certainty is they will get intoxicated but there is no certainty their will destroy their body, everyone thinks that they can stop before too much damage is done and the point is life is not like a video game, we don't have a HUD in the right field of our vision telling us the health of each organ.
People make mistakes, accidents happen.

I don't remember ever seeing a warning label on a bottle of alcohol, and there is no sign that those warnings actually deter anyone from any harmful behaviors. The thing is, governments make entirely too much money off of people making bad decisions because of the outrageous taxes they impose on cigarettes and alcohol that they don't really want to make those things illegal. They want you to make poor decisions and drown your sorrows in your drugs of choice, so long as they make a few bucks in the process. The overall drain on the health care system apparently seems like a small price to pay in the eyes of the government when weighed against the income those substances bring in before the trouble starts for any one person.
Bullshit. That makes ZERO SENSE. The Govt. makes more money by people staying in work and paying income tax than out of work on some drug or another.
Even if they stay in work, if they die well before retirement... that is income tax money the govt can't take.


Should all people who ruin their lives be denied access to quality medical care because they make poor choices? No. But someone who intentionally does harm to themselves over years don't deserve the same respect as someone who had no choice in their resulting health condition. Let people who were born with lousy organs and accidents have priority over people who were too weak/stupid to make good life choices over someone who never had a choice from the beginning.
Ah HAH!

Gotcha. Do you know what is a safe level of consumption of alcohol? Obviously the answer is not no-amount, yet some people can drink vast quantities for years with no ill effect. The point is NO ONE INTENTIONALLY KNOWS the damage they are doing because everyone's body responds differently. It is EXACTLY the same as someone who does some skateboard stunt and breaks a bone. Sure with hindsight it's easy to see where they went too far and injury was inevitable, but you can't see that at the time.

There is no ethical difference between someone who injures them-self accidentally and someone who is injured spontaneously, they did not DELIBERATELY cause this harm, though their actions are deliberately the end result was not.
 

Treblaine

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Frequen-Z said:
generic gamer said:
Well either we give them the transplants or we run the risk of not saving lives because we don't agree with the lifestyle.

"You're an ex alcoholic? No transplant"
"You smoke? Why should we waste lungs on you?"
"You ride a motorcycle? It's your fault your leg's broken"
"Got shot? What the hell were you doing in Brixton? No operation"

If the ex alcoholic paid national insurance then they've contributed to the system and deserve the operation.
This is a perfect example of a slippery slope argument and it is ludicrous. What analogy is there to be made from people damaging themselves with a controlled substance and being shot by someone else with an illegal firearm?

The irony is, I think the top two sentences there are correct, despite your intention being to show people otherwise. If someone damages their own body, why should they deserve other peoples organs?
People relapse, not all, but some, and that makes alcoholics/former alcoholics not without a degree of distrust against them. And when the number of organs is low, like it is, there isn't much justification to giving an untrustworthy (with their organs, at least) person an organ that could be used on a person who had no fault in the failure of their body and are far less likely to re-ruin it themselves.

Whereas, getting shot is not something a person does to themselves (at least, I've not met anyone who's shot themselves and lived to tell the tale) and geographical location is not a legitimate reason to say someone else shooting them is their own fault. And even if it was, not everyone is in a position to choose where they live.
This is NOT a slippery slope argument. A slippery slope argument is "if we allow this, then we allow that".

What about known gang members, if they turn up in hospital with a gunshot wound? Sure, they didn't point the gun at them-self but they DID participate in gangland bullshit and shooting guns at each other over control of drug dealing areas. Should they be refused "valuable blood transfusions" or the "precious time of medical professionals"? Why not save a lot of trouble and give the paramedics lethal injections, put them to sleep LIKE ANIMALS!!
For fuck sake, I like to think the people saying No on this thread are just mind-numbingly ignorant and stupid and don't realise how fascistic their ideas are.

"People relapse, not all, but some, and that makes alcoholics/former alcoholics not without a degree of distrust against them. "

Riiiiiight. So because SOME alcoholics will relapse, then they should ALL be condemned to death?!?!?!? Well you know some people just reject their transplanted organs and it has to go in the bin, and it has nothing to do with their moral choices. That is the main cause of livers failing again, their immune system. THE MOST IMPORTANT FACTOR is getting the BEST POSSIBLE match and that is more important than history of substance abuse.

"And when the number of organs is low, like it is, there isn't much justification to giving an untrustworthy (with their organs, at least) person"

That is NOT HOW TRANSPLANTS WORK. It's not like you have 20 livers and they can just go in any person, each liver MUST be matched. Limited by the geography of transporting a liver to the operating table a liver often it will only match one person. And in the case of liver transplants if you move alcoholics the the bottom of the list... that IS THE LIST. Recovered alcoholics are the main recipients.

Same with lungs and cigarette smoking.

The medical profession is not some tool for social justice.

it is UTTERLY MORONIC to categorically de-favour substance abusers for treatment and transplants, it is CRUEL and goes against the most basic logic of sound medical practice.

Bottom line: for the comments you have made you could NEVER become a medical professional. Well, maybe a plastic surgeon, but that's it.
 

Frequen-Z

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Treblaine said:
My answers in italics, to make this easier to read.

This is NOT a slippery slope argument. A slippery slope argument is "if we allow this, then we allow that".
And how is your overly simplified example any different from what I pointed out? Trust me on this one.


What about known gang members, if they turn up in hospital with a gunshot wound? Sure, they didn't point the gun at them-self but they DID participate in gangland bullshit and shooting guns at each other over control of drug dealing areas. Should they be refused "valuable blood transfusions" or the "precious time of medical professionals"?
If there is someone more deserving and everything matches up for the blood to be used on them? Yes.
Why not save a lot of trouble and give the paramedics lethal injections, put them to sleep LIKE ANIMALS!!
Learn the difference between murder and prioritising a more worthy life.
For fuck sake, I like to think the people saying No on this thread are just mind-numbingly ignorant and stupid and don't realise how fascistic their ideas are.


"People relapse, not all, but some, and that makes alcoholics/former alcoholics not without a degree of distrust against them. "

Riiiiiight. So because SOME alcoholics will relapse, then they should ALL be condemned to death?!?!?!?
Well, that's how the world works and it's naive to think otherwise. I'f I'd fucked up big time, and was trying to fix it, I wouldn't throw a hissy fit when someone says they can't trust me any more. I'd understand and accept that. Would you trust George Best with another liver?
Well you know some people just reject their transplanted organs and it has to go in the bin, and it has nothing to do with their moral choices. That is the main cause of livers failing again, their immune system. THE MOST IMPORTANT FACTOR is getting the BEST POSSIBLE match and that is more important than history of substance abuse.
Fine, if there is nobody else it matches to, then it's be silly to let it go to waste, but if there is someone else it matches to, then the best deciding factor would be a history of substance abuse.

"And when the number of organs is low, like it is, there isn't much justification to giving an untrustworthy (with their organs, at least) person"

That is NOT HOW TRANSPLANTS WORK. It's not like you have 20 livers and they can just go in any person, each liver MUST be matched. Limited by the geography of transporting a liver to the operating table a liver often it will only match one person. And in the case of liver transplants if you move alcoholics the the bottom of the list... that IS THE LIST. Recovered alcoholics are the main recipients.
Like I said, if there's really nobody else it fits, then they should fill their boots. I never said they should be completely denied.

Same with lungs and cigarette smoking.

The medical profession is not some tool for social justice.
And yet, it'd probably be the best tool for the job.

it is UTTERLY MORONIC to categorically de-favour substance abusers for treatment and transplants, it is CRUEL and goes against the most basic logic of sound medical practice.

Bottom line: for the comments you have made you could NEVER become a medical professional. Well, maybe a plastic surgeon, but that's it.
Imagine my surprise. Don't worry, the medical profession isn't something I have interests in. It appears we both value things differently, far too differently to come to any compromise of opinion or anything of the sort.
 

CosmicCommander

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Why should the taxpayer pay for people's lifestyle choices?

Alright, I'm a rapist*, pay me.

It's exactly the same logic, just naked.

[small]*I am not a rapist[/small]
 

Treblaine

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Frequen-Z said:
Treblaine said:
The medical profession is not some tool for social justice.
Frequen-Z Says: And yet, it'd probably be the best tool for the job.

it is UTTERLY MORONIC to categorically de-favour substance abusers for treatment and transplants, it is CRUEL and goes against the most basic logic of sound medical practice.

Bottom line: for the comments you have made you could NEVER become a medical professional. Well, maybe a plastic surgeon, but that's it.
Frequen-Z Says: Imagine my surprise. Don't worry, the medical profession isn't something I have interests in. It appears we both value things differently, far too differently to come to any compromise of opinion or anything of the sort.
You're a Fascist. Plain and Simple.

They ran your sort out of the medical establishment back in the 1940's. You haven't got the FAINTEST IDEA what it means to care for the sick.
 

Frequen-Z

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Treblaine said:
Frequen-Z said:
Treblaine said:
The medical profession is not some tool for social justice.
Frequen-Z Says: And yet, it'd probably be the best tool for the job.

it is UTTERLY MORONIC to categorically de-favour substance abusers for treatment and transplants, it is CRUEL and goes against the most basic logic of sound medical practice.

Bottom line: for the comments you have made you could NEVER become a medical professional. Well, maybe a plastic surgeon, but that's it.
Frequen-Z Says: Imagine my surprise. Don't worry, the medical profession isn't something I have interests in. It appears we both value things differently, far too differently to come to any compromise of opinion or anything of the sort.
You're a Fascist. Plain and Simple.

They ran your sort out of the medical establishment back in the 1940's. You haven't got the FAINTEST IDEA what it means to care for the sick.
And you are angry as hell. I don't recall attacking you, so just chill. You obviously don't like being disagreed with cos you're handling this like a little brat.
 

Treblaine

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Frequen-Z said:
Treblaine said:
Frequen-Z said:
Treblaine said:
The medical profession is not some tool for social justice.
Frequen-Z Says: And yet, it'd probably be the best tool for the job.

it is UTTERLY MORONIC to categorically de-favour substance abusers for treatment and transplants, it is CRUEL and goes against the most basic logic of sound medical practice.

Bottom line: for the comments you have made you could NEVER become a medical professional. Well, maybe a plastic surgeon, but that's it.
Frequen-Z Says: Imagine my surprise. Don't worry, the medical profession isn't something I have interests in. It appears we both value things differently, far too differently to come to any compromise of opinion or anything of the sort.
You're a Fascist. Plain and Simple.

They ran your sort out of the medical establishment back in the 1940's. You haven't got the FAINTEST IDEA what it means to care for the sick.
And you are angry as hell. I don't recall attacking you, so just chill. You obviously don't like being disagreed with cos you're handling this like a little brat.
I see you aren't contesting the accusations, just trying to somehow make this about me. Of course I am angry, anybody would be enraged at the outrageous practices you endorse.
 

Frequen-Z

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Apr 22, 2009
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Treblaine said:
Frequen-Z said:
Treblaine said:
Frequen-Z said:
Treblaine said:
The medical profession is not some tool for social justice.
Frequen-Z Says: And yet, it'd probably be the best tool for the job.

it is UTTERLY MORONIC to categorically de-favour substance abusers for treatment and transplants, it is CRUEL and goes against the most basic logic of sound medical practice.

Bottom line: for the comments you have made you could NEVER become a medical professional. Well, maybe a plastic surgeon, but that's it.
Frequen-Z Says: Imagine my surprise. Don't worry, the medical profession isn't something I have interests in. It appears we both value things differently, far too differently to come to any compromise of opinion or anything of the sort.
You're a Fascist. Plain and Simple.

They ran your sort out of the medical establishment back in the 1940's. You haven't got the FAINTEST IDEA what it means to care for the sick.
And you are angry as hell. I don't recall attacking you, so just chill. You obviously don't like being disagreed with cos you're handling this like a little brat.
I see you aren't contesting the accusations, just trying to somehow make this about me. Of course I am angry, anybody would be enraged at the outrageous practices you endorse.
I'm not contesting them because they are not worth my time and frankly, your opinion of me means less than nothing. And even if I did care what you thought, you've made up your mind, why bother trying to convince you otherwise? Still, if you want to be an angsty hostile little wart, then don't let me stop you.
 

R4ptur3

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Depends on the person i think. If they really want to recover then yes, and if they do, then it's well deserved.
 

Baneat

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Treblaine said:
Rakkana said:
As long as the people with life threatening illnesses get treated first i have no problems.
What? Life threatening illnesses like Cirrhosis of the Liver?

Baneat said:
It's not a question of whether they deserve to die, but someone who damaged their liver themselves should bottom the list with those who couldn't do anything to prevent it.
So you're saying not "deserve to die" more "not worthy of saving". Both sound equally monstrous, it's just some pointless technicality.

How utterly heartless and naive of you, do you think people actually REALISE the damage they are doing? There is now way to know you have fatally damaged your organs from excessive consumption till it is too late.

You're not living in the real world if you think you can keep bumping ex-alcoholics to the bottom of the list because patients keep coming in with "unpreventable" conditions.

The only way to be SURE is to completely abstain from all vices. If you drink and get drunk you are in NO POSITION AT ALL to say alcoholics deserve to die from Cirrhosis as a different roll of the dice you would be in their position. There is nothing special about alcoholism, it just means drinking too much, by its very nature it is very hard to self regulate. You "choice" was to ever take your first drink.

Do you not realise you are setting up a two-tier medical establishment of "preventable diseases" who are basically doomed to languish in pain and suffering and lingering death while the "innocent" patients get priority time, resources and organs. Simply because their medical need was not brought on by their own action.

Utter bullshit. Frankly it is worse than some Orwellian nightmare, it is as society ruled by moral absolutes and a twisted sense of "social justice", hubris mediated by the infulential in their ivory towers, playing god.
Between an alcoholic and a moderate drinker, there's only one transplant available. Going by that information, I'd have to pick the moderate drinker. Both choices suck, but one's slightly less suck. That's not Orwellian, but transplants by definition are playing god, if only to determine the person who gets the most value out of it. Someone who had at least a little control over the situation ranks someone who had none, that's just how it works.