This transcript has been edited for clarity.
Hello, this is Art Caplan. I am in the Department of Medical Ethics, Grossman School of Medicine, New York University.
I’ve been involved in transplants and transplant ethics for years, longer than I remember, how to persuade people to give organs when they die, and make it more attractive to people. I’ve been thinking about how to do it.
It’s something many people still don’t do and don’t want to do, which leaves us with a shortage of organs. Those close to the number of kidneys, heart, liver and lungs cannot be transplanted. Because people do not agree to give them when they die.
At the same time, the demand for organs continues to grow. We have an elderly population, which leads to more organ failure. That leads to more demand. Transplantation is necessary because some people have increased diabetes, have high blood pressure, and are still smoking or drinking alcohol. It may sound sad, but suicide Binge drinking or swallowing bottles of pills can damage the liver and is unsuccessful, so increase your transplant rank.
There are many factors that contribute to the high growth in demand. Also, the capabilities of the US transplant team are increasing. They can take on tougher cases.
Every day in the United States, people die because of the lack of organs. Also, in the United States, very difficult decisions will be made about who will get one of the rare hearts and livers available. Transplant.
The process of deciding who will get one of these organs involves two steps. The first is whether the transplant center will accept you as a transplant candidate, whether it is NYU, Penn, Stanford, or Nebraska. Wherever they are, they need to make decisions about who needs a transplant and whether they think they have the skills or abilities to give them a transplant in a transplant program at these institutions.
When they accept patients, we mainly focus on blood type, tissue type, geographic conditions, and who may be the most ill, and who may benefit. Also pay attention to many that have a national waiting list to distribute organs. There is a delicate balance from the list of countries.
Now, I would like to talk about the situation of people trying to enter the transplant center and the factors that influence the decision. Well, obviously, you need to be in organ failure, and if you’re so sick that they don’t think you can survive the surgery, you won’t be on the transplant list.
People who have access to good medical care and primary care have an advantage in our society over those who do not. Frankly, homeless people are less likely to be on anyone’s transplant list than wealthy people. That is the reality of how medical care and medical care are pervasive in our society.
The transplant center pays attention to other things like lifestyle. They ask, “Are you drinking? Are you smoking? Are you at high risk of suicide? Are you in a substance abuse situation?” And recently, “Are you vaccinated?”
This is a topic that actually causes controversy and controversy. Vaccination status as a condition of admission to the transplant center. My position is whether pre-transplant vaccination helps the transplant work because it builds immunity to infections — COVID-19, influenza, measlesWhatever we can vaccinate — may kill you after a transplant because it is immunosuppressed, and that is a reasonable consideration when deciding who will come to get a transplant. ..
It makes sense to use it to decide who prioritizes transplantation. It’s not about punishing people who choose not to get vaccinated more than they can’t smoke if they’re going to have a heart transplant. This is a decision based on what works and what increases the chances of good results.If vaccination does that, COVID-19 vaccination status or other vaccination status-potentially includes Herpes zosterShingles Vaccine — Appropriate to take into account.
Is that the only thing to take into account? Probably not. Knowing that there are many vaccinated people who are eligible for a transplant, what can a transplant center make properly, ethically and heavily? Say yes.
When doing things like reducing the chances of success with rare, life-saving resources such as the heart, lungs, and liver, the doctor’s duty is to manage those organs for best results and to save the most lives. I think it’s to save the shortage of supply.
Vaccination is related to it, and as it is, it becomes morally related to who is trying to access the transplant. I know many people say that requesting vaccination is just one example of a bully who doesn’t want it. I postpone and say no. The vaccination situation shows another fact, lifestyle choices. This has to do with whether you are likely to survive if you are lucky enough to receive a transplant.
Overall, the most life-saving thing is what we want to happen when the organs are in short supply. In addition, we want more people to donate their organs so that these difficult choices don’t have to be that difficult. Nonetheless, they are, and I think you have to take into account what is medically relevant.
I’m Art Kaplan from the Faculty of Medical Ethics, New York University Grossman School of Medicine. Thanks for watching.
Dr. Arthur L. Kaplan is Director of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles, and a frequent media commentator on bioethical issues.
