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

[Trivun]

I'm all for giving them a second chance, provided they can stay sober. However, there is no way I'd condone letting recovered alcoholics go on a waiting list ahead of other people. People who have always been sober should have priority. Let recovered alcoholics onto the waiting lists, by all means, but they shouldn't be allowed to get treatment before more responsible people, unless it's an emergency case. That's what I think, anyway, and who are we to deny life-saving treatment to people anyway?

 

[Hashime]

If the person's liver went because they were an alcoholic then they should not get a transplant, if it went for another reason they should only if they have been psychologically evaluated and certified as being at very low risk of relapse.

 

[Treblaine]

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?

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 influential 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.

NO. You are playing a moral judgemental role because the history of alcoholism is FAR less significant than almost every other factors to do with patient's NEED. For example:

-length of stay: effectively a first come, first serve, those who have been in need of a new liver the longest are first in line
-match: how close the receptors match and therefore proportional drugs
-Health of recipient at time of procedure and recovery based on how likely they are to survive the operation
-Need: damage to people's liver or other organs is varying and some are in more critical condition than others.

And no practising alcoholic would ever be given a transplant and do I REALLY HAVE TO SPELL IT OUT TO EACH PERSON? It states in BOLD TEXT in the original post that this is concerning Recovered Alcoholics. So this is ENTIRELY down to judgement for past actions.

"Both choices suck, but one's slightly less suck."

WHAT!?!? Both choices SAVE A LIFE. Another transplant will come along, the person who can wait the longest will be made to wait. But if even an ex-alcoholic can is really living day by day on a critically damaged liver then they should be given priority over someone who is in better condition.

 

[manaman]

I'd say it's completely fair to save the life of someone who has worked hard to beat their addiction. Getting over an addiction to anything is incredibly difficult, if these people are really this determined to turn their life around I think they deserve a chance.

The problem is the time. This isn't something where the person stopped drinking years ago and now has issue from his/her reckless youth. This is something where they drink to the point of liver failure then stop drinking for six months and get a new liver. Six months in nowhere near enough time to tell if a person is genuinely able to quit. It's hard to understand an addictive personality without being an addict yourself. Nearly all recovering alcoholics relapse, sometimes several times before eventually quiting. There is a reason people say treating alcoholism is treating a life.

Not that I condone just allowing this person to die, but I would defiantly give that liver to anyone who has not subjected there original one to a lifetime of abuse first, but it's a hard choice when a person cannot wait, when they desperately need a new liver. It's hard to say that this person is going to die, without ever being given a second chance.

What's next? Denying treatment of obese people because they eat too much food? It's a slippery slope when we start to deny people health treatment based upon the circumstance in which they acquired the condition.

This is part of why I don't condone denying them treatment. I don't condone denying anyone treatment. I just believe that with scarce resources they need to go to those that have proved they can care for them first. You wouldn't replace the organs failing in a person from some other disease, until that disease has been treated, otherwise it would be a waste, they will just fail as well (putting aside for a minute the fact that the person would be weak and probably not survive the operation, this is a hypothetical).

snip

The relapse rate is intensely worrying. Very few alcoholics make a long term recovery. I just don't see six months as long enough to prove that this person is capable of caring for the liver they are given. A life time of bad choices is reason to judge a person, especially if they persist right to the point of liver failure (which is pretty much what happens if they quit drinking six months prior to the transplant). Sure people change, but they never change that much. Keep the person on the list, let them prove that they can stay off the booze for a year or so as they move up in priority all the time.

Note I am not talking about denying a recovered alcoholic who has proved over the years prior they have turned their life around anything. Basically what I am saying is that recover rates are abysmal and people quite for 6 months to a year constantly only to succumb to their addiction again. It takes dedication and perseverance to quit. Something easily found during their health crisis, but might not stick with them once problem goes away.

My aunt pretty much died of lung cancer with a cigarette in her mouth. She quit years before when health issues cropped. Once the chronic bronchitis started to go away she started smoking again When she was diagnosed with cancer it was to late, and she just kept smoking till the day she died. My mother side of the family is plagued with addicts. I have watched them all come and go for years from the family events. Unwelcome or unwilling to show at the events every time they relapsed into drug and alcohol abuse.

 

[JanatUrlich]

I believe that people who are still drinking should be given new livers on the NHS too

 

[The Maddest March Hare]

I'd say it's completely fair to save the life of someone who has worked hard to beat their addiction. Getting over an addiction to anything is incredibly difficult, if these people are really this determined to turn their life around I think they deserve a chance.

The problem is the time. This isn't something where the person stopped drinking years ago and now has issue from his/her reckless youth. This is something where they drink to the point of liver failure then stop drinking for six months and get a new liver. Six months in nowhere near enough time to tell if a person is genuinely able to quit. It's hard to understand an addictive personality without being an addict yourself. Nearly all recovering alcoholics relapse, sometimes several times before eventually quiting. There is a reason people say treating alcoholism is treating a life.

Not that I condone just allowing this person to die, but I would defiantly give that liver to anyone who has not subjected there original one to a lifetime of abuse first, but it's a hard choice when a person cannot wait, when they desperately need a new liver. It's hard to say that this person is going to die, without ever being given a second chance.

That's why I specified a bit more in a later post that it should be people who have enough of a clean record from support groups, rehab, medical records and so on, before it is considered. People who have put a few years and a lot of effort to quit completely, not just people who have managed a few months without alcohol who could be prone to relapse.

I completely agree that someone with a history of alcohol abuse needs to be thoroughly screened before being given a liver, as it could act either as a chance to start a new life, or as a chance to start drinking all over again.

But I think that if there is sufficient proof that they have already and will continue to turn their life around for the better, the chance should not be denied.

 

[Hammer's Girl]

What treatment (if any) did this person get?

If it was just AA sessions I am not surprised at all.

He never attened AA, he refused to accept that he had a problem. He was on antidepressants but stopped taking them because they made him feel ill when he drank (but he drank because he was depressed, go figure)

Mountain climbers choose to put themselves at risk - deny treatment.

Screw treating them, we shouldn't be wasting the money to rescue them in the first place

 

[Treblaine]

What treatment (if any) did this person get?

If it was just AA sessions I am not surprised at all.

He never attened AA, he refused to accept that he had a problem. He was on antidepressants but stopped taking them because they made him feel ill when he drank (but he drank because he was depressed, go figure)

Mountain climbers choose to put themselves at risk - deny treatment.

Screw treating them, we shouldn't be wasting the money to rescue them in the first place

If you want my completely amateur psychologist opinion, alcohol was not his problem just a symptom and corroborating factor, he has deep problems with his psyche/personality that needs expert one-on-one treatment.

He needs therapy, not just anti-depressants that he doesn't even want to take. Again, I'm not a psychologist, but I am very familiar with the medical field from a family of doctors and medics, and refusing to take psyche meds is a major warning sign of deeper problems.

It's one thing to have mental demons, but another to not want them fixed.

the "pills make me sick" sounds like an excuse, a rationalisation. It may be true, but that he'd rather be clinically depressed than a bit sick... worrying.

What can I say, there are some bad apples. You can't judge the rest of the barrel by them.

Actually, just by chance I was reading the feedback section of the New Scientist magazine and it covered the issues of casual alcoholism. I mean you seem to greatly object to people who have "intentionally damaged their bodies" but did you know a Drinking more than just a single Beer can (about a pint or 500ml) per day then you begin to do damage to your liver. And that's just for men, for women even a single beer per day is over their safe "limit" which may not even be enough to intoxicate some people. Every time you do damage your liver it becomes easier to damage on later occasions.

You will be amazed how many people who would not consider themselves alcoholics at all drink about 1 bottle of wine per day then they may need a liver transplant at retirement.

So don't be so quick to judge, not all alcoholics are "self-harming" with alcohol or attempting "suicide by bottle". For so many they simply made mistakes. They were ignorant, they didn't know or thought they could manage the risk. Every time someone drives a car - even when sober - they are taking a calculated risk, we think we can manage risk. But the very existence of hospitals and the medical establishment shows not-100% of us can.

The thing about the Liver is it can be significantly damaged and still appear functional, people don't notice, they can "feel fine". Cells die but enough remain to keep the body ticking over, till it reaches a tipping point where there just aren't enough cells left and a cascade begins, toxins build up that the liver can't remove quickly enough and more liver cells die.

So "wine-bottle per day-ers" and "pub-binge per weekend-ers" who pass liver-enzyme test only mean they don't need a transplant YET! Proper tests are more expensive and invasive.

So if you consume more than about a single Beer/Wine-glass per day you are a hypocrite to say alcoholics don't deserve liver transplants... or at the very least you are damning yourself.

 

[Aaliah Christy-Davis]

nope nope nope nope. they shouldn't be given liver transplants.

 

[wkrepelin]

I voted yes but let me add a caveat: you must be sober for 5 years. Six months is play-school frolics, it shows the beginning of a commitment but, statistically speaking, is not long enough to be reasonably confident the person will stay clean.

 

[RadiusXd]

I don't think you can be quite as black and white as your poll suggests.

 

[SadakoMoose]

The answer is always yes. When you can save a life, do, no matter who it is. If you feel uncomfortable with your money being used to save people that you don't like, emigrate somewhere else.

 

[T3h Camp3r T3rr0r1st]

nah, they had their chance, if they decided to start drinking then they should have done what I did, cut myself open, remove half my liver, drink forever... EPIC WIN!

Wouldn't you need to wait for the rest of it to grow back though?

THATS LOSER TALK!!!!