patrick.net

The gall of this guy Jobs.

Ethics have nothing to do with it. Money has everything to do with it. Larry Hagman, alcoholic extraordinaire, had a liver transplant even though people probably died waiting for the same liver. I didn't catch whether Jobs received a whole liver or whether it was a partial that will (hopefully) regenerate. But the truth is that rich people receive treatment when the rest of us die for the same malady. If they can't receive treatment under their top-shelf insurance policy, they pay cash.
The question is whether or not it's fair. And obviously, it's not. Healthcare should not be an option in this world.

I don't give a shit what money says. Far too long has the specter of money hung over the aspirations of so many.

I want to know what you think about it. The decision process you use to justify this thought too.

Hey, when you buy meat you pay by the pound. If he's willing to pay $$$$ he deserves it. All that extra scratch he dumps into health care system will pay for a couple illegal alien operations-maybe even invitro-fertilization!

Hell yeah it's ethical for him to have a transplant! Pancreatic Cancer can be horribly painful and invasive. However, if caught in early stages there's a possibility of success. Who are we to say he can't have an opportunity to live a little longer, a little healthier?

Frodo, I've specialized in working with the elderly population. I was speaking with a stroke patient who has the use of one arm and above her neck yesterday (not a coincidence, I have many conversations like this one on a regular basis). She told me that in her dreams, she's walking. My point is that if she was offered the opportunity to have a surgery that could make her walk again, she would. It would do no good to point out to her that the success rate of such a surgery for a person who hasn't walked in over ten years is close to nil. If the possibility was there, she'd want to take it no matter how slim it was.

Same thing with Steve Jobs. He got a liver. He may still have the big C, or may possibly have received chemo & radiation that zapped it altogether. If he had it, it may come back with a vengence later on. But in the meantime, he'll have a healthier body and therefore a better opportunity to enjoy whatever life he has left (whether a year or twenty years).

The medical ethics of money and priveledge are different, tho. Mr. Jobs received a transplant well ahead of many other deserving people, merely because he could afford it. People are waiting to be placed on lists because they lack insurance; once placed on the list it could be over a year before they receive a transplant. The wait to be placed on Medicare is TWO YEARS. So, if someone is disabled because they need a transplant they're looking at around three years if all goes well. Only they'll be dead first. Ugh.

(Elliemae nimbly hops off her soapbox, praying she doesn't sprain an ankle)

A liver transplant is not a cure for cancer. Who cares how many livers he gets. Steve has been one of the most unique individuals on this planet. If a new liver buys him some time to figure out how to beat this cancer, maybe we can all learn something.

What does frodo think of it? Nomo?

There is nothing wrong with it, as long as it is a voluntary transaction between the receiver and the receptor. If I need an organ, I may travel to China or India to get a cheaper transplant because I may not be able to afford an American organ.

If money cannot buy life extension, what is the use of money anyway? If you criticize Jobs, you should criticize anyone who is paying top dollars for medical resources, which is available in scarce quantity, so winning medical resources is absolutely a 0-sum game. The fact that you are employing the best doctor means someone else cannot get access to him for the same time, and that someone else may die faster.

Unless Jobs forced someone to "donate" him an organ, even if he pays money to jump the queue, it is completely ethical. This is the basis of capitalism, money can buy almost everything.

Basic healthcare, which is not in scarce quantity, should be made available to everyone. Fairness can only be implemented on the basis of abundance. When certain commodity is scarce, jungle rules apply.

Most cutting-edge medical technology, by nature, should be very very scarce. It is only too natural that most people in the world do not have access to it. Asking everyone to get a "fair chance" at the best that medicine has to offer is equivalent to asking for a 10,000sqft mansion for everyone. Even if you want to apply the fairness principal, how do you know that a 10-year kid next in queue who may grow up to be a drug addict should be more valuable than Steve Jobs, who may drop dead 2 months after the transplant? There is no way of applying fairness in this, so the most fair principal is money.

Liver transplant Jobs who is a vegitarian... should have had a better balanced diet. More meat and skim milk!!! Word to the wise have a burger and milk shake already!

What does this have to do with the housing crash?

zeta -- that has nothing to do with it. There are millions of vegetarians and vegans around the world who have perfectly 'balanced' diets. There is nothing in meat or dairy that can't be obtained elsewhere, especially for a billionaire.

Kevin - Just having fun with the Vegi-heads! And I agree it hasnt much to do with the housing 'correction' we are seeing.

Kevin asks what this has to do with the housing crash? I suspect that the op didn't move it to the misc thread, and he's & patrick are the only ones who can do that.

I'm not criticizing Steve Jobs. If I or my family needed a transplant, I'd walk to the ends of the earth to get it. A simple comparison is medications - if I need medication that my insurance denies, I'll pay out of pocket. Is that fair, considering that there are people who go without medications because they can't afford it? Hell, no - it's not fair. But is it ethical. I would say it is. The more basic question is why the insurance would deny medication in the first place - and why there are people without insurance whose health and lives are in jeopardy because they can't afford meds.

There's a guy in Vegas - Jerry Herbst - who has more money than I'll ever see in my lifetime. He works hard & plays hard, and has earned that right. But he has an arm that doesn't work - nerve damage I think - and no money in the world will make it better. If there was something that could be done, he would do it. Jobs got a liver transplant, and regardless of his co-morbidities or how he got it, he has a chance at a longer, healthier life. Good for him. :)

I don't have an ethical problem with it. Can't quite articulate why... but my first reaction to the question was that it wasn't a problem, preexisting condition (cancer) or not.

http://www.sltrib.com/ci_12480371?IADID=Search-www.sltrib.com-www.sltrib.com

This is the story of a woman who has specialized in and taught medical ethics throughout her career. There's always the question of quality vs. quantity - as in, will you add quantity to your life but be miserable the entire time due to the side effects of the treatment you'll receive. Qualify for a shorter period of time is sometimes the ideal, rather than extending a lifespan. However, when it's you or your family member, the definition of quality varies.

HA!

I'll edit to the misc forum, as that is where I intended it to go in the first place.

As for my opinion.

I am literally in the fence. My initial reaction is NO. Here's why:

Viewing it from a social perspective, that is, one in which the greater good rules. I think the ten year old kid wins, I think this because I think that a ten year olds life is more valuable than Mr. Job's life. I personally see little value in what Steve has to offer any more.

Maybe I am wrong and you would like to tell me why.

I welcome it.

Wasn't Steve Jobs pancreatic cancer cured? I read that it was a particular type they were able to eradicate.

For those that think money is a horrible way to ration scarce organs, how about increasing the supply? You know, condemned prisoners for livers or hearts, and 3rd world volunteers for kidneys, eyes, or other parts you only need one of to live. After all, that murderer's liver could give a new lease on life to that teenager who would have died without it. A third world person would lift the family out of poverty for generations for the selling price of one kidney, and the recipient gets to live.

Well, frodo, we don't know if the liver he received was usable by someone else. They have a limited lifespan, and there needs to be a ready/willing donor on the table. Some people spend forever on the transplant list because of their blood type or other issues.

I can see that ten year old kid has value and hopefully a long life ahead of him - but is it more valuable than Mr. Job's? Greater good is difficult to perceive, if Steve Jobs lives longer and keeps more people employed than the kid would have the greater good would be for Jobs. On the other hand, if the kid had an IQ of 180 and would have cured cancer plus fixed my transient cell phone service, the greater good would be for the kid to live.

We'll never know - it's all subjective.

HA!
I’ll edit to the misc forum, as that is where I intended it to go in the first place.
As for my opinion.
I am literally in the fence.

Either you are in a lot of pain (I hope it's not a picket fence!), or else you meant that you are figuratively on the fence (or, more simply, just 'on the fence').

I don't have any issue with rich people getting organs more easily than poor people any more than I have issues with rich people getting big houses and everything else that comes with being rich. I see the fact that there are people in the world worth more than a million other people to be a bigger problem than the specific things on which people choose to spend their money.

The biggest problem with organs today is not supply in and of itself -- the biggest problem is compatibility. A healthy organ is only viable for a short period of time (usually less than 48 hours), and the odds of finding a compatible donor and getting the transplant all done within that limited window is slim.

The biggest obstacles that have to be overcome are:

- Technology to extend the lifetime of organs outside the body. If we could get organs to last as long as blood, there would be viable organs for everyone who needs them.

- Increasing the diversity of the donor pool. Asians in particular are massively under represented as donors, due mostly to cultural taboos. There are plenty of donors of european descent, but compatibility drops off a cliff when you try to find a european donor for an asian recipient.

I also think that we SHOULD have incentives for organ donation. This might mean a small up front payment when you agree to be a donor (hell, waving the DMV fees for the license might do it), or maybe even a guaranteed payment to your family when you die (like life insurance). The arguments against incentives are weak, and mostly rely on slippery slopes to matter.

The most likely scenario is, there are so many Apple fans out there, and I won't be surprised that one of them on the death bed wishes to donate his organ to Jobs and Jobs only. Sorry 10-year old kid, you haven't done enough to deserve such a treatment.

I tend to believe that Jobs has far more advantages than people who are just rich. He has influence.

In other countries, people sell organs, which I don't see as a problem. Organ is something that belongs to you and you only. If someone on his death bed wants to start a bid to make his family's life better, I'd say go for it, and those who have enough resources to make his family happier should get the organ. Organ is a private property, not public property. Donors are being extra nice, but they don't need to be. They can be more commercial and decide if they are about to die, they should sell their private property to the highest bidder to benefit those they love, which is fine with me.

My impression of Steve Jobs as a human being is not very good. There are plenty of stories about his shenanigans. For example, when he got a $5000 bonus that he was supposed to split with Steve Wozniak, and then said he had gotten only $600 to split in two (see Wikipedia for more details).

He probably could have been a star realtor if he wanted to.

Nevertheless, I wish him good health.

I read a medical story about a mature woman who received the heart of a young motorcyclist who was killed in a motorcycle accident. After her surgery, she started craving beer and acting differently. Mingling organs can produce unintended consequences that may not be worth it. If you have no spiritual beliefs and think there is no afterlife, I guess you would do anything to prolong the agony here.

My guess is that co -mingling organs may potentially change your values, your personality, your job, your social behavior etc. Getting the organs of someone else sounds like the biggest risk on this planet - especially since you have little choice in whose organs you receive.

Talk of bodily organs and co-mingling...what the hell???

I read a medical story about a mature woman who received the heart of a young motorcyclist who was killed in a motorcycle accident. After her surgery, she started craving beer and acting differently. Mingling organs can produce unintended consequences that may not be worth it. If you have no spiritual beliefs and think there is no afterlife, I guess you would do anything to prolong the agony here.
My guess is that co -mingling organs may potentially change your values, your personality, your job, your social behavior etc. Getting the organs of someone else sounds like the biggest risk on this planet - especially since you have little choice in whose organs you receive.

I'm not sure that I believe these stories, which are anecdotal and inflamatory. Of course, these stories couldn't be anything but anecdotal... However, whether they're true or not, the fact is that thousands of people's lives are saved every year from stem cell transplants, organ transplants (including skin), and the like. When a person has to choose between an organ from an anonymous donor or death, it's an easy choice.

Kidney transplants are perfect examples of life-saving & enhancing transplants. A close friend has had his kidney for over 20 years and has lived a full life. Had he continued on dialysis, he wouldn't have had the freedom, the health, the opportunity to work full-time in a professional capacity, and most importantly, the ability to be a loving father & grandfather.

The major obstacle in organ donation is the cost - which, because of our medical model is out of whack. A live kidney donor sometimes has to pay for their own donation and associated healthcare costs - which is why you'll see donor jars at the quickie-mart. The after care is expensive, including therapy & anti-rejection medications.

Then, there's always the emotions of a deceased donor's family. Letting go of a formerly healthy person is damn hard.