Giving a donor liver to an alcoholic, who only quit drinking upon diagnosis? Hell no. There are people with 5+ years who still worry about relapsing. A year is a start. Being forced to quit? I’d have wished her good luck if they gave the liver, but the person who dies instead of her?
I’ve watched alcoholics die of liver failure. It is a horribly sad thing. But sobriety is a choice, and you don’t get to go back in time to make it. I’m not sure why this article is spinning this as cruelty from the transplant board instead of maybe, just maybe, highlighting the destructive role that alcohol plays in society. I wonder if a booze company pays their bills or something.
Did you bother to read the article? Her partner was a match, and could have donated a portion of their liver to her, if approved, as opposed to a donated liver.
Judge someone all you want for their previous life choices, but the decision referenced in this case should have been between the two of them and their doctor.
Did you bother to read the article?
Did you? Her liver was so far gone, doctors did lot believe a partial transplant would work
Second paragraph in: 'However, documents show the Alcohol Liver Disease (ALD) team at UHN rejected her in part because of “minimal abstinence outside of hospital.” ’
The article quotes Dr. Jayakumar making a general statement regarding alcohol diseased livers, but the University Health Network declined to comment on Amanda’s specific case outside offering their (patronizing) condolences.
Feel free to quote the article and back up your statement.
“minimal abstinence outside of hospital.”
This means she kept on drinking while not hospitalized
The rest is standard boilerplate, they can’t speak about her detailed case in public
I’m sorry, maybe I’m just daft this week, but I missed the concept “the doctors believed her liver is so far gone, a partial would lot [sic] work” in that.
I quote: “Huska, he said, stopped drinking as soon as she was diagnosed with Alcohol Liver Disease on March 3 and had also registered for an alcohol cessation program to begin once she was discharged.” So where does the article state she kept drinking while waiting for the transplant?
I’m sorry, maybe I’m just daft this week, but I missed the concept “the doctors believed her liver is so far gone, a partial would lot [sic] work” in that.
This was posted like 5 times and I assumed it was the same article… I’ll find the link to the original one where they detailed this. In any case, she was not eligible because she was likely to go back to drinking and ruin the new liver…
So where does the article state she kept drinking while waiting for the transplant?
I never said that… what the article says is that she was an alcoholic since late teens and was never able to stop. She literally only stopped drinking after she found out she was going to die, and that was only like 3 months. She tried to quit before but never succeeded… that tells you she was a super high risk of relapsing
“This means she kept drinking while out of the hospital”, which directly contradicts the statement by the boyfriend saying she stopped drinking.
Everything else is like, your opinion, man.
Yes, I read the article three times over, trying to chase down false info someone posted in here. His offer is irrelevant. The prognosis was not good enough for him to donate. They only included it in the article for the melodrama. It’s nothing more than an “I would die for her!” moment. Well, I’m glad the medical board did not condone assisting him with suicide.
Please quote the article where it states her prognosis was not good enough for him to donate. All I’m seeing is a statement that her prior alcohol consumption was a factor in that decision.
I completely disagree. People should be able to make mistakes. Stopping upon diagnosis is the best she could have done. If she continued drinking after getting a new liver, that would be a different story.
I hate this “get shunned out of society because you aren’t perfect” culture.
That would be nice if we had an unlimited supply of livers to transplant. Give everyone a chance.
Unfortunately I’d still rather give whatever liver we have on hand to someone guaranteed not to wreck it immediately, because giving her a chance means taking away someone else’s.
No, not in this case, they weren’t taking away someone else’s chance. But you didn’t read the article. Her boyfriend was a match and wanted to donate part of his liver. Donar A wanted to give to recipient B, there was no recipient C losing out. It was a closed loop.
“No amount of determination from the (partner) could bend the decision,” said the physician. “There was no process for a second review or appeal. Just a harsh finality … goodbye.”
She many have not even been the drunkard you all are assuming she was. If you go out once a month, and have 3 or 4 beers, you’re not eligible for a liver transplant. That’s ridiculous. You may not drink the other 30 days of the month, but that one Saturday ruined it for you; you die.
A life was forfeit, because some bean counters in white coats -probably not teetotalers themselves- deemed her not worthy. Even though it cost more to let her die,
Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day
A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
Her partner is the one saying she had an alcohol substance use issue. It’s not “assumed” she was a drunkard, he stated it. I agree she should have been given the liver- she quit alcohol, she had a donor. We shouldn’t punish people with alcohol use issues by killing them.
The liver wasn’t thrown away, it was given to someone else. The liver still saved a life, unfortunately it wasn’t hers.
Unless you’re talking about the boyfriend’s liver, in which case the doctor determined her condition would not survive a partial transplant, and the attempt would just kill her sooner.
I was talking about the general disturbing nature of determining organ transplants, yes I know re: the live donation from her bf
So again: The liver wasn’t thrown away, it was given to someone else. The liver still saved a life, unfortunately it wasn’t hers.
Imagine being the person denied a liver because they gave it to someone with a chronic alcohol abuse problem to “give them another chance”.
Cutting out someone’s liver to transplant isn’t easy nor risk free. You are risking death to have a low probability of saving someone. It doesn’t matter if they are volunteers.
Oh, way to move the goal posts!
Basically - fuck this person, right?
Isn’t it about her chance to get one though? “There was no process for a second review or appeal.”
You have a window were you can’t drink any alcohol for biological safety reasons, but in this case the mere rule of not drinking alcohol was enforced. This makes it a punishment instead of some biological requirement.
Some time ago I had to go under general anesthesia to have some teeth pulled. Local anesthesia didn’t work. I wasn’t allowed to eat for 24 hours. But I was so hungry that I ate just enough to not have stomach pain anymore. In the hospital I said I ate a tiny bit, and they said that it wouldn’t be much of a problem if I only ate a bit. Compared to the OP story, I wasn’t punished because I was still within the safe window.
Why should somebody get punished by a hospital? They should be neutral. “Oh you drank alcohol? You’ll have to come back later because of safety reason”. They shouldn’t be the judge. Giving them that power is just stupid.
Doctors are cops. Acab.
Adab
I assume you were not getting a transplant? The risks of regurgitation during surgery is in no way comparable to the risk of relapse in someone with hx alcohol use disorder in early remission. Addiction is a terrible beast. I am sad that she died too, but we have to blame the systems of addiction, not the medical board.
Nope. This seems like a stupid rule.
Transplant guidelines in Ontario and much of Canada require patients with ALD to first qualify for a deceased donor liver. If they don’t meet that criteria, they aren’t considered for a living liver transplant, even if one is available.
It was perfectly possible with her partners liver. This is just “no you didn’t do what we want so we just let you die”, and you’re here trying to justify that.
That is because her boyfriend could only give her a partial transplant (he cannot donate his whole liver) and the doctors did not think it would work as her liver was too far gone to recover with a partial transplant
The rest of your comment is so far from reality or logic, I’m not going to bother addressing it
Medical notes suggest she started drinking in her late teens and had tried – unsuccessfully – to quit. After periods of sobriety, she returned to alcohol, which could increase the risk of continued use after the transplant.
Allen says Huska registered for an addiction program early on in her hospital stay to stop drinking after she’s discharged. Hospital records also say she suffers from anxiety.
From the first article CTV made about this, linked in in the first sentence they posted. Seems like we need to actually fund mental health care in this country or something, because she’s obviously been struggling for a while. You can see how the board would weigh previous failed attempts to quit against her.
You did not read the article. Her partner was a match and willing. The hospital blocked it because she didn’t pass the test for a liver from the donor list.
Lol I quoted something from not just this article, but a second article they link to from the one above, but sure.
They blocked her, at least in part, because she was an active alcoholic who had not shown any signs of changing her behaviour outside of time inside the hospital. Something that would have weighed on their decision included medical information such as previous attempts to stop drinking. Mental health care, including healthcare for addictions, is lacking in Canada. You can’t force someone to go into rehab, but offering better care and options might have helped her in the past.
As said in the main article as well as the one I read, in order to qualify for a living donation you need to qualify for a full donation, because if something goes wrong you’ll need a full liver ASAP and get bumped to the top of the list.
So she was supposed to die because she had an addiction? What some call a disease?
Are you trying to argue that alcoholism shouldn’t be a factor AT ALL for liver donations, or that living donations shouldn’t also need to meet the standard full liver donation standards?
I’m wondering what you are arguing.
I completely disagree. People should be able to make mistakes.
You are allowed to make mistakes… What you are not allowed to do is skip the consequences
It’s not like you can pick a liver at Walmart and give it a try. That liver could save someone else, giving it to an alcoholic is likely to only buy her a tad more time untill she relapsed
It’s incredibly sad to hear someone die of a preventable cause this young, but I can also somewhat relate with the people who reviewed her application.
If a living donor wouldn’t have been sufficient, they’ve now created two patients where they previously had one, and without improving the primary patient’s condition. It makes sense that a donor organ from a deceased donor would be preferable.
That said, the current requirement for the patient to meet deceased donor standards for transplantation to be eligible to use a willing living donor make no sense. Both situations should have their own unique criteria, given that a living donor situation involves different risks for both the patient and the donor than a deceased donor situation would incur.
Ultimately this whole situation boils down to a scarcity situation though. If we want to solve this, it will require more people to register themselves as a donor and a review of the eligibility criteria as soon as more donors are available.
And how prevalent and socially acceptable Alcoholism has become.
It’s not just acceptable, it’s encouraged by the province to keep people from rage quitting their lives here.
How has Polievre not tried to capitalize on this tragedy to pitch his “your bank is a better death panel than the transplant math” plan yet? American healthcare is half his platform!
As a former American, you do not want the American Health Care System unless you are very wealthy. It is an expensive bureaucratic disaster. BC Health may be imperfect but at least I am not paying us$700/month for family insurance that might be accepted by the doctor/hospital that sees me in an emergency.
He has a platform? Every time I check is just angry “I’m better than Trudeau” statements
I donated a kidney to a friend earlier this year. The reason his kidneys failed wasn’t anything he was at fault for, but even if it had been because of poor decisions he’d made in the past, I still would have given him one of mine. Because people deserve second chances. I can understand not wanting to give a recovering alcoholic a deceased donor’s liver, when someone else could receive that liver, instead. But this woman’s partner was a match and was willing to donate to her. What’s the harm in that? That isn’t a liver that could have gone to someone else who needed it. It’s a donation that would have either gone to her or no one else. No one could have lost out of the donation had been carried out. This was just cruelty, and now someone is dead. And for what? Because there’s a 15% chance (according to studies the article mentioned) that she might have started drinking again???
It’s not super clear, but the article makes it sound like if a partial graft from a live donor fails, then the recipient is automatically fast tracked for a new transplant from a deceased donor.
If that’s the case then maybe policy should be changed in the case of alcohol abuse.
The policy isn’t there just to be extra nice, it’s because otherwise the patient dies without a liver.
Since she was too sick for a partial liver transplant, and not eligible for a dead donor full liver transplant, she would have just died.
It might seem cruel but the same is done for a lot of other procedures; if the chance of you dying in surgery is way too high, doctors won’t take the risk, they’re not executioners.
It’s not a moral judgement about her alcoholism, the same would have been true if she had a cancer no surgeon would take on.
I totally understand the mortality aspect, I was just thinking if a patient is 100% going to die from liver failure without a transplant, any chance to live from a live donor seems worth it. Of course I don’t know any statistics so I have nothing to base it on.
Maybe euthanasia should be a legal option instead of a slow agonizing death that puts next of kin into medical debt.
Surgeon time is precious as well.
In the article, it shows that the hospital spent significantly more slowly letting her die than the average cost of the transplant.
The comparison is apples and oranges. They only include the cost of the surgery itself, not the cost of after-surgical care, the potential cost of complications to both the patient and the donor, etc. Then there’s the cost if the partial liver donation doesn’t take, or if the patient relapses.
Obviously, there’s also a lot of potential upside to having the patient survive, I just don’t think the odds of that were all that high.
So let the free market sort out the organ redistribution problem!
I’m a free market entrepreneur and I’d like to solve your organ shortage and homeless problem all at once.
D:
There are more people who need transplants than there are organs, so the medical profession has to make decisions about who to deny. This was a reasonable decision, in my opinion.
I’d be inclined to agree, except that her partner wanted to donate HIS liver and was prohibited from doing so as a living donation due to the alcohol use determination.
In Canada, drinking more than 3 drinks per week is medically considered “high alcohol use” for a woman… (6 for a man). This limit keeps getting lower year after year
If this can prevent you from getting organ transplants, then it encourages lying to your medical doctor about your current habits… That lady was not considered alcoholic, she just used alcohol in greater amount than the limit considered acceptable by doctors.
Latest stats show that almost 4 out of 5 people has exceeds that limit at some point in their life. This woman died only because she was honest with her doctor about her alcohol use. (Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol. It’s not about lacking donors.)
That’s total bullshit. As a IT professional I have a nightly drink after work for self medication. Never two. Just one.
Just do what I do and put it in that deep cupboard above the fridge. Then forget about it for literal years by mistake. It’s doing wonders for my health. Just wish I could do a version of that for my bad sleep schedule.
I’m guessing you can stop at any time if you want to? I’ve known older healthcare professionals that have approved and even encouraged one drink a night, but our understanding of the effects of drinking has evolved. I doubt doctors keeping up with the science would encourage it at this point. It would be like having someone come in that’s overweight. It doesn’t mean you’re unhealthy now, but it may be a factor that needs to be kept in check and working on it could prevent issues in the future.
Yes I can and have stopped. I drink 2-5 times a week and it’s one 40 proof 1oz (not a shot 1.5oz) over rocks with a bit of soda. Same or less than a beer.
This isn’t two shots neat daily or a six pack of beer. Sometimes I go a week without. Other times it’s 5 times a week.
Just remember if a doctor ever asks then lie and say only on friday, there’s a few things in life you absolutely have to lie about because the system is not designed to care about people.
Here in the uk never admit to smoking weed to a medical professional, never admit to even so much as thinking about any form of self harm, delusions, emotional regulation issues… it can come back decades later and fuck you over.
Wait what happens if you admit to smoking weed? I thought we had doctor patient confidentiality. I’ve had some mental issues in the past, though not to the point of self harm. What happens if I admit these? I also live in the UK and this is concerning.
This is generally pretty bad advice.
I mean I get where you’re coming from, and I cannot speak to what it is like in the UK (I can only speak as a man in the US), but you should not lie to your doctor.
If you see a doctor, and they start treating you differently after finding out that you smoke weed, then you find another doctor.
Unless you’re in Canada and there’s a doctor shortage and you can’t just shop around for a different family doctor if you don’t like your current one. If you’re lucky enough to even have a doctor here…
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This woman died only because she was honest with her doctor about her alcohol use
No, and it even says so in the article
She quit about 5 months before her death when transplants require 6-12 months of sobriety. She was drinking regularly with the fucked up liver before that diagnosis, and liver damage isn’t something that just suddenly appears.
She kept drinking despite what would have been intense cramping pain and a slow death, thats why she was denied (addiction) and ultimately died
Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol
And as the article also says it’s incredibly dangerous for someone to get a live-donor transplant when they’re in bad shape like she was, as failure of that means they’ll need to let her die on-table or transplant a good dead one into her (which she was denied for, due to her drinking)
It’s sad, but this woman died to alcohol abuse, pure and simple
That’s a lot of vague statements you’ve repeated from the article. What’s drinking “regularly” (this was before the diagnosis as you’ve stated)? “She kept drinking”, what does that mean? How much alcohol was she consuming? Did she have a sip of her friends wine and was honest about it so was rejected?
as the article also says it’s incredibly dangerous for someone to get a live-donor transplant when they’re in bad shape like she was, as failure of that means they’ll need to let her die on-table or transplant a good dead one into her
Where does it say that? You’ve completely twisted the statements.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day, A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
In 2021, 15.6 per cent of Canadians over 12 engaged in heavy drinking – a term defined as five or more drinks for males, or over four for females, on one occasion at least once per month in the past year.
Heavy drinking is drinking ONCE per month in the past year. If this is based off of before her diagnosis, you’re gonna exclude like 80% of the working population who actually does go out for drinks or private occasions (unless they just lie which I guess they should’ve in this situation). Between the price of keeping them alive but not fixing the problem and there being no “review” process for decisions, I would categorize this as a bad system that allowed a preventable death from an alcohol related disease to continue.
The only genuine hint to the real reason of the refusal was “minimal abstinence outside of hospital”.
Let me ask you bud, if you needed a liver transplant to continue living, would you have even one drink per week, or would you just quit completely?
Very biased article.
Plus, regardless of her husband being compatible, it still costs the state tens of thousands for the operation. In no way would it be ethical to put a new liver in someone who refuses to completely abstain from alcohol.
That’s absurd. Refusing someone a transplant because they used to drink more than 3 drinks a week before they knew they even had liver problems is completely absurd. Calling her an alcoholic for that is even more absurd. What in the world are these people or you thinking?
“minimal abstinence outside of hospital”. That means she was still drinking.
Given her condition it’s possible she never left hospital after her diagnosis
Are you on purpose missing the point?
The point the person you replied to made is that she didn’t completely stop drinking alcohol once she was diagnosed to have a terminal liver disease due to alcohol use.
So first of all, she must have drank a lot more than 3 drinks a week to have terminal liver disease in her 30s that’s due to alcohol (yes, all of that is in the article)
But the issue is she didn’t stop drinking after being diagnosed, she reduced her consumption but didn’t stop it.
If any of the above is incorrect, feel free to correct us, but making a point that’s completely missing the facts that are being talked about here doesn’t add anything to the discussion.
The first point is correct. The second one is shown to be wrong in the second paragraph.
The issue here is you need to have stopped 6 months or more before, and she was only diagnosed 5 months before she died.
As an alcoholic, I initially agreed. Don’t waste a liver on me. Then this:
Even pleas for a living liver transplant, with Allan offering to be her donor, were not entertained.
What the actual fuck.
Takes up valuable hospital times
No. A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor. But she wasn’t eligible, so a partial transplant was just a death sentence.
It’s not like giving away part of your liver is a zero sum game, now that person is at risk of infection, has lesser liver performance, and for what? Someone who has showed they will just continue to harm themselves, and others (the person they’re getting the liver from,) if you allow it?
I don’t know any other surgeons who would do that.
If a surgeon refused to let me save the life of the one person in the world i love then they wouldn’t be able to save any more lives after that so add that to your heartless calculations…
Yes these people should indeed be killed for letting another human die for no good reason.
There are very few transplant surgeons who would take the risk of a partial liver transplant which they have high likelihood of being a death sentence for the patient (not sure if you read but they need a full liver, from a cadaver, not partial,) and want to willingly throw their name in with another patient to discuss during M&M.
This is coming directly from familiarity with the procedure, comorbidities, and other factors from a general surgeon at a top 10 hospital in the US.
Has lesser liver performance? What? Do you understand how a living transplant works? You both regrow a full liver after the procedure, because livers are so regenerative you can make a full one from less than half. This makes no sense to me.
Also she quit for 5 months after she found out she had liver failure.
It takes years for a donor’s remaining liver to grow back, and the recipient is unlikely to grow out more of the donated liver depending on comorbidities and severity of illness.
I’d have supported her paying out of pocket to use the live donor that was willing, but not to use my tax money when it’s pretty fucking clear she has no intention of changing.
It’s the same reason I’m largely against the Liberal’s diabetes funding - ~90% of diabetics are Type 2 (I’m willing to help Type 1’s out because it’s not their fault) and the vast, vast majority of those are from unhealthy lifestyle even if they are genetically predisposed.
If were going to have a public health system, people should be required to take care of themselves. And no, I’m not talking about the one-off accidents from riskier activities (although I do think people should bear the cost of their own healthcare if it’s the result of criminal activities), I’m taking the problems that occur as a result of abusing your body for years or decades.
Thats a dark road to tread.
An example,
no alchol consumption is safe, so using your line of thinking you’d need to argue that anyone who partakes of alcohol at any anytime would fall under that line of thinking
Processed red meats simailary, especially those treated with nitrites, so those eating bacon, ham etc shouldn’t be entitled to public heath care under your reasoning
Or are those things ok becase you do them ?
On the upside, now you’ve excluded 95% of the population, public healthcare will be cheap :)
Contra to most peoples thinking, if you’re concerned about public healthcare costs, you should “encourage” obesiety and smoking, they all die early, most health care coats are associated with healthy people in their old age. See here
https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html
Adults are stupid and greedy, we all are.
Perfect, let’s just get rid of public healthcare then
Threads like this always bring out the uninformed. It’s great. Easy to block them. Fish in a barrel.
it does not cost the state A DIME, because it is insurance that covers healthcare, not taxes.
The loss is unrealized potential of those who are sick. so, that means the state invested like 150.000 bucks in one citizen, in hopes to get like one million bucks out of them
(not out of them specifically, but out of their labour; it is a chain, you see, and the labourer pays taxes, the factory pays taxes when selling the product, the consumer pays taxes when buying the product, and so on)
alcohol and obesity by diabetis harm EVERY cell in your body, period. thats hard biochemstry, facts, it is the truth.
red meat, on the other hand, is quite unclear.
the studies involving red meat are interesting;
people self report by remembering long periods of time, a salami pizza counts as red meat, as does a whole mc donalds burger with fries on the side.
as for nitrate, this gets complicating. you seem to be on the right path. nitrates are a new topic for me, i never before read up on them:
https://www.diagnosisdiet.com/assets/images/5/nitrate-content-45165560.png
https://www.bbc.com/future/article/20190311-what-are-nitrates-in-food-side-effects
this is so tedious, no wonder everybody has a different oppinion
Until there is a diet that has long term success for a majority of its users I don’t think this mindset is healthy or realistic.
“According to the latest weight-loss research, 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss.” source
So I drink more pop than I should. Why should I have to pay more for my healthcare than my buddy who had a habit of timing running green lights as soon as they turned green. That isn’t illegal, either, yet it’s very risky behavior. It didn’t work out for him just one time, and he nearly died. Why should taxpayers have to pay for him?
The answer is because the vast majority of us engage in risky behavior, or just have the bad taste of passing on our poor genetics to the next generation, and the social cost for penalizing people for not agreeing with societal norms are too high. This includes drug use, even legal ones like alcohol. Sure, don’t spend limited resources such as donated livers on people who aren’t willing to make the lifestyle changes required to make it worthwhile, because someone else will probably have to die for that to happen. But if we could make new livers and the price was reasonable, I wouldn’t even be against that.
If your buddy who likes gambling with green lights was convicted of a traffic offence as part of that accident he should have been on the hook for his own healthcare and the healthcare of anyone else he hurt.
Way to miss the point. It’s a good thing you don’t engage in any risky behavior, or anything that would have a negative impact on your health. I mean, it’s not like you would be a hypocrite, right?
I never said “Don’t engage in any risky behaviour”. Stuff like cardiovascular and lung diseases and Type 2 Diabetes doesn’t happen over the course of days, weeks, or months, you have to be chronically treating yourself like crap for years to get to those points.
Free climbers don’t usually die the first time, either.
You should pay for their healthcare, because you have a contract with an insurance company.
What makes you think that I, posting in a Canadian community about a Canadian article, have a contract with a healthcare insurance company?
oh, sorry, there was much talk about public health insurance, i Of course don’t have a clue how that works in canada. sorry, my fault. I only focused on public health care, here in germany thats an insurance, i was ignorant.
Not a problem. It’s essentially rolled into our taxes for the most part in Canada. You may have health insurance on top of that, but that isn’t a guarantee and usually is a top-up of our universal coverage. This usually covers things like drug prescriptions, glasses, and hospital conveniences such as semi-private or private rooms. I agree with the general idea, though, that we as a group pay for everyone who is covered. My original point at the top of this thread is that removing people’s eligibility simply because of risky behavior can be very tricky and likely harmful to society.
If were going to have a public health system, people should be required to take care of themselves
On the face of it, this sounds sensible. But, thinking more deeply, who should decide the required amount of care a person ought to take? Ideas about what it means to ‘take care of yourself’ are varied. And consider that some citizens of this country are simply unable to take the same personal health decisions that others have the privilege to take without a second thought.
What you’re talking about here isn’t a public system. A healthcare system that only serves certain chosen people is not public in any meaningful sense.
A public healthcare system is imperfect on the whole, but on average, when funded and administered properly, is structured to apportion care based on need, instead of the profit motive. I think that’s worthwhile, and the right thing for a society to do from a moral standpoint.
no one bothers that it is THE PEOPLE that pay for their health insurance, not the state.
the state made insurance mandatory, thats the only thing it is guilty of.
Type 2 diabetes has a stronger link to family history and lineage than type 1, and studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes.
Now that you know you were cruel and wrong about diabetes, what do you have to say? What about the type 2 diabetics that have a perfect lifestyle and still have type 2 diabetes?
You’ve gotten a lot of downvotes but rather than doing that I want to explain to you why your position here is flawed.
First think of every lifestyle activity whether it be food, motorcycle riding, music, etc. Now consider that there are some activities that are statistically safer than others.
If we took your position to the point of being law why would we stop at food lifestyle choices? Why not just any risky lifestyle choices? Eventually you end up with a society where individuals have less choice and freedom and are constantly obligated to live the safest possible lives.
You and I both know that isn’t a desirable outcome. We should be empowering people to live the lives they choose and encouraging them to be healthy, not punishing them for make the “wrong” choice.
I attempted to address this but perhaps I wasn’t clear:
Yes, some activities are risky then others, however many of them have absolutely 0 negative impact on you unless something major happens all at once. In fact, many of them have major health benefits for the vast, vast majority of participants.
Contrast the above to overeating, chronically eating stuff that’s not good for you (ex. excessive sugar, salt), drinking too much, doing lots of drugs, smoking… that kind of behaviour will basically screw up everyone who partakes given enough time and has no positive health benefits at all.
You talk about a loss of freedom… I’ve already lost freedom by paying for a bunch of people who purposely fuck themselves up for no tangible benefit to themselves. There is stuff that would be good for me that I literally can’t afford because of the amount of taxes I pay.
Here’s an idea for your route of encouraging healthy lifestyle rather than removing freedom: include a physician form in my taxes where my doctor attests that I am generally in good shape (given my age) and he has no reason to believe I am doing anything that is a risk factor for chronic cardiovascular or lung diseases, diabetes or related chronic illnesses, and give me a significant tax break for doing so.
Right now you’re on the internet instead of being physically active, that’s a health risk.
Who says I haven’t already gotten enough exercise today?
You’re aware of the concept of overworking your body, right?
Who says how much it’s acceptable to eat or drink?
I don’t care if you’ve gotten enough exercise, you would be healthier if you were walking around the block right now instead of sitting inside on the internet. Since my taxes pay for your medical bills I get to tell you how to live your life, so get walking!
Great, so maybe you can stop paying for my healthcare and I can stop paying for yours.
come on guys, step over your ego.
Consider what you just said can apply to motorcycling or buying a classic car with outdated safety features. There is no tangible health benefit to motorcycling or driving a classic car, it basically “has no positive health benefits at all” (as per your own words) and only increases risk. Show it be banned? What about every other risky hobby? If not, then neither should eating junk food which is measurably less dangerous/risky. Keep in mind that for smoking the overall trends of diminishing smoking habits in younger generations basically highlights the proof that encouraging healthy habits rather than punishing the individual is the correct way to approach this.
Buying a motorcycle or classic car doesn’t necessarily lead to injury in the same way that overeating and being lazy to the point of becoming a land whale does.
I suggest you look up just how often motorcycle injuries/deaths happen. What you’re saying only applies if you never get into an accident or fall off the bike ever, in the entire period it is owned (which could be 20-30 years). Something which is incredibly unlikely. From the language you’re using (i.e whale) I’m getting the impression that your position isn’t rational and instead based on a dislike of overweight people. I’ve done what I can here but I don’t think you’re messaging back in good faith and don’t want to entertain the perspective of someone who tries to put others beneath them based on their body and eating habits.
I’d be willing to bet that the number proportion of motorcycle owners with health problems caused by riding is a hell of a lot lower than the proportion of people who don’t eat right and don’t exercise enough and have health problems linked to that.
And no, it’s not just overweight people I don’t like, it’s also people that are sick all the time (like, weak immune coughs and colds type of stuff).
Being a judgmental asshole increases your likelihood of being assaulted. I shouldn’t have to pay your medical bills when you get punched in the face by a stranger.
Free expression bud, it’s my right to be a judgemental asshole. Take that up with Pierre Trudeau.
What a shitty attitude.
A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor, or she would die in operation.
Since she wasn’t eligible, a partial transplant was just a death sentence.
Liver failure is terminal. She was invariably going to die without the transplant. She wanted to receive the donation, her donor wanted to donate. If the success rate for a living transplant is zero that’s one thing, but that’s not being claimed here since she wasn’t eligible for procedural reasons.
They said it was viable in the early stages, and with a decent success rate. Just not the success rate they wanted, and for some daft reasons you need to be eligible for a full transplant from a dead patient to get a partial transplant from a living donor. Makes no sense.
Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day
A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019. “It’s a shame that so much money was spent keeping her alive under such horrendous circumstances and putting her family and her partner under such stress when the remedy was a lot cheaper and could have happened much, much sooner,” said Selkirk.
The survival rate of patients with alcohol-related liver disease who receive a deceased donor liver transplant has steadily improved to reach 80–85 per cent at one year after a transplant.
Can anyone make this add up?
I’m quite torn on this issue, my sister donated her kidneys and liver when she died. On one hand people who need an organ, need an organ but on the other hand deceased persons organs are so rare that they should go to those with liver diseases they have no medical control over before those who are sick from an avoidable disorder.
I don’t like to think of my sister’s liver going to someone who would abuse it over someone who just happen to have a genetic liver issue. She lived a life too short bringing joy and education to many children, her final act saving others would be soured by someone wasting it.
I guess you can also think of alcoholism as a disease too?
Some could consider it a mental disorder.
Compared to an autoimmune disease that attacks organs and glands, I’d think the autoimmune patient should be top of the list. Probably good that I’m not on death panels though.
I completely agree that alcoholism is a disease, and as with any other disease, we have to look at the survivability if she got the transplant.
Let’s be honest, while the article tries to be favourable to the patient, you can piece together the facts and see that her odds weren’t good. While she’s been sober since she got the diagnosis, it appears she was immediately hospitalised which tells us she was in very rough shape and has only been sober while in the hospital. Even if she was able to stay sober, it looks like the odds with a partial transplant aren’t great.
It is, or at the very least is a symptom of another one. I have all kinds of addiction issues which is why I must be super careful in my life. I am a former alcoholic who used to drink nearly every day from basically after work until I was too tired to keep going. I also have ADHD and possibly ASD (the latter not officially diagnosed as of now). There seems to be some evidence that those can play a role in addiction.
Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
I’ve come to the realization the only ones getting us off the dark timeline is us. I’m in USA, ready and willing. Thinking through what beginning steps I can take.
I didn’t like the cost section, because it felt simplistic. The actual procedure might be “cheaper”, but it doesn’t take into account the long term costs if something goes wrong with the “cheaper” option. Living liver donation is different from say a kidney, you’re taking a part of someone else’s liver.
“The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor,” said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
I worry people are going to see those numbers and run with them, even though there’s more to consider than that. Financial calculations in medicine are always difficult, and it feels dirty no matter what
The article is not clear. Is the $71k price listed the cost of the surgery itself or surgery + hospital stay?
If it is just surgery then it is a very unfair comparison since the ICU stay would have been needed in either case, and at least some of the days in the ward for recovery.
Plus living donation means the donatee needs recovery time and a bed as well.
So some rough numbers I found from places online for rough estimates. Also, the link the article has for bed costs is actually to a study on liver transplant costs.
On average, 25 days in hospital between pre/post transplant. Of that, seems like a few days (varies by person) is in ICU. So thats 50 days of beds for the two of them, with say a week of combined ICU time.
Plus two surgeries - the article only takes an average cost of liver transplants, which is not indicative of a second surgery needed for a living donor transplant.
That puts the cost up to ~240,000-300,000. That cost is close enough that I can see it not being a factor for the decision.
As grim as it might be, transplants are handled by apathetic, risk averse math and little else. Loose organs and surgeons are far from common.
Honestly I find that the opposite of grim, I wish more problems were solved in a cold and calculated way.
Like killing disabled people because it’s cheaper, farming slaves to provide cheap labour, that sort of thing?
There a good reason we tend to prefer the more humane and emotionally guided solutions over the mathematically most efficient.
That’s only true if you are optimising for profit. You can make a purely logical argument for caring for people.
I thought this was about kidneys instead of livers and was very confused.
Jesus Christ that’s fucked up. Only 36 too and stopped drinking… and had a willing living donor. What do you do in this situation when they won’t help you? Go down to Mexico?
And why the fuck is alcohol taxed so damn high then? I thought that was the compromise.
It’s taxed the way it is, because the only drug that kills more than booze are cigarettes.
Those taxes also go to help innocent people who are harmed in crimes that are often related to alcohol, like domestic violence, assault, and auto-incidents, also things like uttering threats and mischief.
domestic violence, assault, and auto-incidents, also things like uttering threats and mischief.
Crimes most committed by the police?
I agree with the general vibe of police are bad, in Winnipeg they recently killed a woman because they were driving off-road in a park at night, but the idea behind “sin taxes” are generally as a deterrent, as well as a way to try to mitigate damage to others.
I’ve been to places that are “cop bars” unknowingly, so the porcine populace may have have a DV-juice problem.
Fair point
Jesus Christ that’s fucked up. Only 36 too and stopped drinking…
From the article:
Amanda Huska died Aug. 15 after spending six months in an Oakville, Ont. hospital.
and:
Huska, he said, stopped drinking as soon as she was diagnosed with Alcohol Liver Disease on March 3
So that sounds like she was immediately admitted (which implies she was already very sick) and only was sober in the hospital. In my opinion, that doesn’t qualify for “stopped drinking” and unfortunately she didn’t get a chance to prove whether or not she was actually able to stop.
How much do you need to drink to get ALD at 36?
It seems the average in the US is 10 years. But you can develop it and reach critical levels in as little as 5 years. Hard alcohol every day. Multiple times a day.
Jesus…
Typically, a huge amount. But genetics may have been an issue, as well.
Partial transplant from a living donor was not viable for her. It would have immediately failed, leaving her with no liver at all, and then she would have died because she wasn’t eligible for a full transplant. Doctors will not perform a procedure that guarantees death. The article explains this
I read the whole article and never saw that
But doctors say that people with severe liver disease from alcohol use may need more than just a partial living liver donation to thrive.
“The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor,” said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
Guy you were responding to wasn’t entirely accurate with what the article says, but general idea is there. If the partial liver fails, then they immediately get added to the full liver list, which is why they need to meet the full liver list requirements. Based on how end-stage she was, it sounds like its less likely the partial would be successful.
I was reading through the article and I think the policy in question is this
Transplant guidelines in Ontario and much of Canada require patients with ALD to first qualify for a deceased donor liver. If they don’t meet that criteria, they aren’t considered for a living liver transplant, even if one is available.
Also this
“The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor,” said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
As for why that is, I’m not familiar. I’ve asked someone else and I’ll edit in more if I learn more
Well, stopped drinking when she got the diagnosis, not before, didn’t comply with medical advice to stop drinking before hospitalization, and as they said in the article there are a lot of criteria for a living donation, and it’s only an option if you otherwise qualify for a donation because of the possibility of rejection requiring an urgent transplant.
A different article said they were trying to raise funds to get the transplant done at an unspecified European hospital, so “yes”. I think it’s telling that they didn’t go to the US, a north American country, or specify the country.
It’s worth remembering that the only people who can talk freely are the people who were decided against and are talking about suing.No one wanted her to die, but with organ transplants it’s a case where you’re more or less picking who will die. Phrasing it as being punished for bad behavior is unfair to the people who need to decide which people are likely enough to benefit, which isn’t easy.
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Because, it’s a risk-reward calculation. If the patient doesn’t qualify for transplant, then the expected risk outweighs the expected reward. In this case, the risk isn’t just to the patient, but also the donor, and by extension, the medical system itself.
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I didn’t catch the part where she relapsed after diagnosis. For fucks sake how much was this lady drinking to get liver failure at 38?
heavy drinking – a term defined as five or more drinks for males, or over four for females, on one occasion at least once per month in the past year.
What the article calls heavy drinking, would have been nothing to me when I was an active alcoholic. Towards the end I’d be drinking anywhere from a pint to a fifth of bourbon a day. I was an active alcoholic for over a decade, running from age 23-33. I’m thankful that I was able to sober up, celebrated 5 years sobriety (from alcohol) a few months ago. Saved my life.
Congratulations! My wife drinks a ton and has since high school. I make her get blood work done regularly and the worst that happens is inflamed liver.
She drinks like 3 of those boxes Costco wines a week so at least 2 bottles a day. Sometimes liquor on weekends. She just turned 40
If I were you I’d try to switch off to smoking weed instead. Much healthier, no hangovers, no adverse side effects, and so much cheaper! A chronically inflamed liver leads to some bad things, and dying from it is not pretty or gentle
Not a chronic weed smoker, but how does weed help? Does it fulfill the same need?
And isn’t this just trading lung health instead (and throat health, though I imagine alcohol isn’t great for your throat either)
It fulfills the same need of “something to mark a time of relaxation.” while being much less detrimental to your health. Low temperature vaping and edibles are as low-impact as you can get to your lungs. Additionally, even if you opt for actually “smoking” the flower, you’re only ever taking a few hits (or if you’re like me, on most nights just one!) so it’s exponentially less harmful than cigarette smoking.
I don’t drink more than twice a month. I do have an addiction to sparkling water however.
Maybe I can get my wife to switch though, I’ll try! Thanks for heads up.
It actually takes surprisingly little if it’s done consistently and without giving your body time to rest.
A standard drink has roughly 14g of ethanol in it. People with notable liver damage tend to have a history of a decade or more drinking 30-50 grams a day, or two to three drinks.
People who drink more than 80g a day for a decade are almost guaranteed to have liver problems (~5-6 drinks).Obviously drinking a half gallon a day is worse, but consistent long term drinking is also not great.
It is essentially a poison that’s only around because it’s easy to make and traditional at this point.
I believe this is FALSE:
[she] relapsed into drinking while on the transplant list,
Where does it say this? I reread it 3 times. That’s a huge part of the story and not one you should just make up!
Not made up, I just read a couple other articles that mentioned it.
It’s also part of the whole “the only people who can talk freely are the people with an interest in the doctors being wrong”.People aren’t turned away because they didn’t exercise or because they work too much or they don’t get enough sleep or they didn’t follow doctor’s orders. So, in Nathan and Amanda’s case, you’re seeing someone being told, ‘You didn’t follow doctor’s orders, so we’re not going to help you. We’re going to let you die’
As a quote from the other interested party, as well as the “in documents shared with CTV News, notes show […] their decision was based on ‘minimal abstinence outside of hospital.’” is pretty much spelling it out.
‘minimal abstinence outside of hospital.’”
I’m not sure why folks seem to think ‘minimal abstinence outside of hospital’ is a smoking gun. That’s pretty much how medical staff should document an alcoholic whose sobriety only began while hospitalized. It means she hasn’t been able to quit drinking!
In isolation it’s not great, but in conjunction with your own advocate talking about you not following a doctor’s orders? It doesn’t bolster confidence that the individual would follow doctors orders in the future.
It means she hasn’t been able to quit drinking!
Yes, that’s exactly the point. It’s quite unlikely her medical troubles started when she was hospitalized.
A history of not following medical advice casts doubt about a future of following medical advice.Yes, addiction is a disease that the individual may lack the ability to control. That doesn’t change that it’s a risk factor for non-compliance that’s absent in others who need the transplant.
whoa wait a minute. I didn’t realize which comment i was replying to. I read three different articles and found NOTHING stating she relapsed.
I do similar documentation and I can promise you that “minimal abstinence outside the hospital” does NOT mean relapse.
I’m gonna have to ask to see the citation or ask you to delete your comment for misinfo
I re-traced my steps, and the source was both dogshit, and didn’t site primary sources. I edited the original comment to convey non-compliance before hospitalization was required.
Ultimately “was sick, didn’t listen when doctors said to stop drinking” conveys the same doubts that “tried to stop but failed” does about suitability for a donor liver.
Somehow I read the article thinkingshe had a kidney problem which we have two of.
How can her boyfriend even donate his liver? Wouldn’t he die?
Something interesting about the liver is that we can regrow it. So it might be possible to take a portion of a liver, put it in another person, and then both those pieces grow into a full or well-enough-functioning liver. I’m not a physician and I don’t know if such a procedure has ever been attempted.
I believe that’s an established procedure. Both the donor and the recipient regrow full livers from the portion they have. You can only donate once though because of how the new liver tissue is structured. I believe the arteries in the new one aren’t in the same place.
Edit: if you read the article it actually tells you her boyfriend was willing to be a live donor.
maybe this is a joke going over my head but you just described a liver transplant. what blew my mind was learning that they don’t take the old liver out, they just squish the new one(the healthy liver sliver if you will) in and let it do it’s thing
My understanding is that’s the case with kidneys as well. If there’s enough room, they don’t bother removing the old organ because that just introduces more chances to make a mistake.
Seems like we knew about stem cells before we even knew what they were…
If you are going to make alcohol consumption a bar to a liver transplant without making alcohol illegal you should all go fuck yourselves. You had a drink and you should die should not be a thing.
This isn’t what happened though. She was addicted to alcohol, per her partner, got diagnosed with needing a new liver, she immediately quit alcohol, and they denied her anyway even though quite a bit of time had passed while she was sober. I am unaware if her liver disease was because of the previous regular alcohol use. It wasn’t just 1 drink though.
Yes, organ donation is messed up. I met a girl dying in hospice once. She needed a new kidney. Genetic stuff, and then when she was 15 she tried to kill herself with Tylenol. She got her first transplant before the suicide attempt. She was denied a second one due to the suicide attempt itself. There are only so many organs in the world. She died in agony in hospice, young and covered in calcium deposits.
We punish substance use and mental health so harshly in this country. No one deserves the death penalty for previous substance use, especially for alcohol which is ancient af. It’s horrible she was denied when there was a liver already available.
We punish substance use and mental health so harshly in this country
It’s not punishment, any chronic illness will make someone ineligible for an organ transplant. It’s not saying it’s that person’s fault, it’s a situation of “2 people need this organ, which ever you choose the other will die in agony, one is more likely to live twice as long as the other.”
He was only offering the organ to the one person though
What does your second paragraph have to do with that?
It’s horrible she was denied when there was a liver already available.
Any full cadaver liver that could have gone to this woman didn’t get thrown into the garbage — it went to someone else who would have died without it.
As for the living donor liver her boyfriend offered, even though he was a match her level of liver failure likely meant that the partial liver her boyfriend could have donated wouldn’t have been successful. Living donors still need a liver for themselves, and we each only have one full liver — so the best they could have done is given her half a liver. Her condition was too poor for this to have a likely positive outcome, which was why this was also denied.
It sucks, but there aren’t enough donor livers for everyone who needs one. The cadaver liver she was denied however would have gone on to save the life of someone else you’re not hearing about in the press — someone else who may have died without it.
If the unfairness of it all upsets you that much, then make sure you’ve signed your organ donor card, and make sure your family members know and understand your desire to be an organ donor. And encourage the people you know to do the same. This is only a problem because there aren’t enough donor livers for everyone — when you have n livers, at best you can save n lives — and thus having a larger number of donor livers allows for more lives to be saved, with fewer qualifications.
It’s hard to say if she would have lived or not.
I think a bigger discussion about medical gatekeeping and bodily autonomy is warranted here
I have been an organ donor since my first driver’s license
From my limited knowledge organ donation criteria are horribly restrictive on a personal scale but unfortunately make sense on the macro scale. Organs are such a scarce resource that as I understand there’s no other option.
This girl’s death was undoubtedly a tragedy, but as fucked up it’s to say if she lived someone else would probably die in a similar agony. Was she treated fairly - I don’t know, can we make this system better - I unfortunately also don’t know.
One easy way would be to make organ donation opt out instead of opt in. As in, if you do nothing, you’re an organ donor if you end up brain-dead, and if you don’t want to, you have to explicitly opt out. Alternatively, we could just say any brain-dead person may have their organs harvested, regardless of what they declared while still alive. After all, you don’t need the organs anymore once you’re brain-dead. (I’m specifying brain-dead, because if you’re completely dead, then the organs are also useless)
That would help to some extent with scarcity in opt-in countries. But there are already opt-out countries which still face the same dilemma. Because if you’re even one organ short how do you fairly decide who’s gonna die… Can you even fairly decide about someone’s life and death…
Organ donation panels are a sick Trolley problem come to life. I don’t know either.
How come we’ve managed to make artificial heart but not artificial kidney or liver?
Pump make blood go weee
Liver and kidneys have to filter and sort various chemicals to keep them from poisoning your body.
Also, dialysis is a thing, it’s just generally external cause of the complexity.
Artificial kidneys are in the test phases. Not sure when they’ll enter trials but it’s very complicated.
I just learned this last week that when someone gets a kidney transplant, doctors don’t remove the old one, they just shove it aside and patch the new one in…and honestly, that’s kind of fucking me up.
The liver is one of the most complex organs in the human body. It is responsible for a wide spectrum of toxin breakdown and chemical synthesis. The heart only needs to pump blood, though it’s uptime is very impressive. If your liver stops working you won’t die immediately but if your heart stops working your body will be starved of oxygen in mere minutes. Ultimately though what the heart does is mechanical and simple.
