Wednesday, June 6, 2012

Who Lives?

I wrote this post months ago and thought I had published it, but recently I found it as a draft.  So, I'm publishing it now, despite the fact that much has happened in the Trayvon Martin case since his tragic shooting and in the organ donation world. Post-traumatic Stress continues to be an issue for vets and others who have experienced psychological trauma.

Too busy to check news over the weekend, I found out this morning that former Vice President Dick Cheney, 71, had received a heart transplant over the weekend.  Well, that's nice.  However, isn't he a bit old?  Surely, someone much younger could have been a match for that donor heart?  I thought that guidelines existed for age, health status and other criteria that needed to be met for someone to receive a transplant of any kind.  I recall when Larry Hagman received his liver transplant and what a hoopla that caused because of his age.  But really, who is to decide who lives with a transplant and who dies without one?

Sometimes the decision hangs on a donor match.  If there's no match, no transplant.  People have died waiting for that elusive match.  I understand that a transplant is the very last treatment option, after the doctors have exhausted all other options.  Some organs are easier to transplant than others.  For example, small intestine transplants have yet to gain much success at all.  Cheney happened to need an organ that has enjoyed much success with transplantation.  But what if there was a donor heart that matched both Cheney and an 18-year-old college freshman, what criteria decides who gets the heart?

Source: Hoffman/Getty Images
The snarky part of me grumbles that Cheney was too old, that heart should have gone to someone younger.  But what if the match was only for Cheney and no one else?  Then someone younger could not have benefited.

Oh, and then who's going to pay for that heart transplant?  Medical insurance providers do NOT like transplants.  They are really expensive.  Cheney probably has enough money to cover the cost himself.  But what about someone else whose insurance vetoes paying for the procedure?  Or what about the person who has no medical insurance at all but is a match for the donated organ?

I am suddenly thinking that doctors are not the only people in our society who decide who lives or dies.

There's George Zimmerman (on the right), that Neighborhood Watch guy with a gun (why on earth was he carrying a gun?) in Florida.  He made a decision that Trayvon Martin (on the left) was not going to live.  Or maybe he meant to only wound the 17-year-old and he's a terrible shot.  But Zimmerman made a life-and-death decision in the moment he pulled out his gun and aimed.  He held Martin's life in his hands and he threw it away.  Was Zimmerman qualified in any way to make that decision?  Somehow, I don't think so.

On any given day in this country, someone makes a decision to end someone else's life.  Making the decision and acting on it are two different things.  A high school bully who tells his victim that he's going to kill him may not have the weight of the action of the bully who actually does kill his victim, but it still carries considerable weight for the kid he's bullying.  I'd call those kinds of threats terrorization with the intent to harm someone psychologically.  But we have no laws against that, to my knowledge.  Psychological harm really doesn't count, not like physical harm.

Tell that to our soldiers who return from combat with Post-Traumatic Stress.  They've survived all manner of physical threats.  Those physical threats carried for them the effect of making them feel powerless, helpless, vulnerable, in a life-threatening situation.  So, they live physically in our world when they return home, but psychologically, they're still trying to gain power over that life-threatening situation.  This is extremely painful.  There are no brain transplants that could alleviate their suffering.

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