Young Man Denied Heart Transplant Because He's Autistic

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Thinking of this on a macro-cosmic level, it does make me wonder - we are headed towards a rapidly aging society in the Western World, by percentage and numbers, and with that comes increasing levels of dementia. From estimates that I've read in articles, this could cost billions to deal with. On the other side of the demographic continuum, you have vastly increasing numbers of people born on the autism spectrum who need extra help to make it in life. So the question becomes, do we divert more resources to the increasing numbers of people on the autism spectrum, or allocate the lion's share to the 65+ group? Who should get priority, those on their way out who have already made their contribution to society, or those coming in who still need to make their mark in life and be productive, healthy and happy citizens for many decades to come?

Clearly, one of the greatest ethical dilemmas ever to face the Western World.

It certainly makes sense to try to maximize the likelihood of success when prioritizing how to dole out rare resources like a donor heart. Picking recipients best able to participate in their post operative care makes sense to me. I don't at all agree with any value judgement that automatically discounts someone's eligibility based on a diagnosis of something as variable as autism.

I don't think many people would argue against the idea that someone addicted to illicit drugs, alcohol, or cigarettes should be a much lower priority than someone who is not. This seems clearly practical simply because of the complications that chronic use and abuse of those substances would cause in the regimen of anti-rejections drugs, not to even mention how they might compromise the health of a heart more generally.

Taking an extreme example of arguing that a child who is not yet literate should be a lower priority than someone older who is able to read instructions themselves for the administration of post-op drugs and so forth wouldn't make any sense. At another extreme, I think that making the value judgment that someone who is a Nobel laureate still in their prime for example should be prioritized ahead of someone less accomplished is an uncomfortable decision, but one that has its practical value to humanity. I think these extremes show that applying those same judgments to patients with autism that affects their ability to participate in their own care and affects their contribution to humanity as a whole probably isn't entirely invalid.

If Paul Corby is already dependent on a pile of medications making drug interactions and other problems a major factor I can see why that would count against him. If he already suffers from a mood disorder and other psychological issues that might be unpredictably exacerbated by the steroids necessary to prevent tissue rejection following a transplant, then I can see how that would make him a lower priority at well. If Paul Corby's behavior and capabilities for following through with post-operative self-care might be substantially detrimental to the likelihood of success with a transplant, then I think those things should factor in the decision.

The thing that I'm sure we can all agree upon is that a value judgement about the worth of Paul Corby to the world and a judgement about his potential success with a transplant should not be made is a snap decision based on the diagnosis of autism. As I hope we all agree to some degree, there are plenty of worthwhile attributes that can come along with the impediments of autism, and they don't appear in a consistent mix between one person on the spectrum and another.

My assumption is that anyone in Paul Corby's position would want a fair evaluation of their individual potential and not a blanket determination based solely on a label like autism. I hope that if he didn't get that initially, then the attention his situation is now garnering will help to ensure he gets it eventually. I hope that not only for his sake, but for any others on the spectrum who find themselves similarly situated in the future.

In their eyes, the doctors are basically saying "why give a perfectly-functioning heart to a subhuman ret*d when we can find a promising young normie athlete?" Let's not beat around the bush, Doctors. This is the same program of eugenics and "cleansing" Adolf Hitler promoted, yet you take an oath not to do any harm. How will you answer that, Doctor? There is also discrimination regarding ethnicity when it comes to transplants as well. The American Journal of Kidney Diseases published a report indicating that members of the African-American/black community were over 30% more likely to not receive a transplanted kidney.

Son-of-a...

Just for that, I'm going to put myself on the donation list but put a clause in my will that says my organs can only be given to others with autism. See how they like it. <_<

Autism would have absolutely no effect on the ability of the heart transplant to save his life, and therefore in listing it they've admitted to discrimination. Had they left it at the abundance of medication then perhaps this complaint would have no bearing but they did and it does.

And if we try and fine-cut it that becomes an inward spiraling trap of perfectionism.

Okay, take age, instead of having a hard and fast cut-off that no one past such-and-such age be eligible for being put on the waiting list, a more general rule that it someone is expected to have 20 years of life post-surgery that is plenty good enough. And if someone wants to argue that this should be 15 years or 12 years post-surgery as the standard of plenty good enough, I might well be open to that, too.

And importantly, if we can make the donation process more honest and decent and high road for families of recently-deceased potential heart donors, then the number of available hearts is not fixed.

From reading the article I gathered that one of the main reasons is because he already has uncontrollable violence due to some psych issues which may be exacerbated by his AS, and the steroids he would have to take would probably increase the violence. I assumed they decided that because treating his violence would entail something extreme like heavy sedation or restraints a lot of the time, that the quality of life he gets from the heart would be less than the quality of life someone else would get from it. I could be wrong, and if I am please point it out to me because I'm not trying to argue or defend them if they are discriminating, but that's just how I understood the article.

If my interpretation is right, then I don't think they are saying that someone who can't do the same things as someone else is in any way less than others. I think they are saying that because there are so many more people in need of a heart than there are donors that they want to give the hearts they have to people who can get the most out of them. Yes, that's a value judgement, but I can see where they are coming from, and I can see where his mother is coming from too. If he would be sedated and sleeping his life away or tied to a bed or locked in a room because the steroids made his violence worse, wouldn't it be better to give the heart to someone who could enjoy the life it gives them?

I'm not saying that because of his AS he couldn't enjoy it, I have AS and know that has nothing to do with whether or not you can enjoy your life, but because of how his life would be after the transplant, due to the increased violence caused by the meds he would have to take, that just seems to be prolonging his life just to make other conditions worse. If it wouldn't make other problems for him worse, then I could see feeling that it was discrimination. But why not give it to someone who it wouldn't cause more problems for?

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Part of the criticism of the decision is that his issues with violence are overstated (I suspect they are no worse than anyone else who has meltdowns) and there are alternative medications to steroids that would not affect his behavior as steroids do.