Their Hearts Are In The Wrong Place

Rob Stein in The Washington Post:

The nation's organ-transplant network is considering giving younger, healthier people preference over older, sicker patients for the best kidneys.

Instead of giving priority primarily to patients who have been on the waiting list longest, the new rules would match recipients and organs to a greater extent based on factors such as age and health to try to maximize the number of years provided by each kidney - the most sought-after organ for transplants.

"We're trying to best utilize the gift of the donated organ," said Kenneth Andreoni, an associate professor of surgery at Ohio State University who chairs the committee that is reviewing the system for the United Network for Organ Sharing (UNOS), a Richmond-based private nonprofit group contracted by the federal government to coordinate organ allocation. "It's an effort to get the most out of a scarce resource."

Worst idea of the year. It's one thing to argue, as I do, that our society overspends on end-of-life care because patients and families haven't faced up to their mortality. It's quite another to say that a 20-year-old is more deserving of a new kidney than an otherwise healthy 60-year-old.

Dr. Andreoni appears to be in the thrall of kidney idolatry. The gift of the organ is nowhere near as valuable as the life it saves -- and when it comes to human lives, well-meaning medical ethicists shouldn't be exempt from our hard-won rules against discrimination on the basis of age. The same utilitarianism could be used to justify a preference for choosing an able-bodied transplant candidate over a disabled one, and from that point the slippery slopes run in a dozen other directions.

Alzheimer's Myths

Sandra Day O'Connor (who lost her husband, John, last November to Alzheimer's disease) and two medical experts on the urgent need for more research as the baby boomers age:

Experience has taught us that we cannot avoid Alzheimer’s disease by having regular medical checkups, by being involved in nourishing relationships or by going to the gym or filling in crossword puzzles. Ronald Reagan suffered the ravages of this disease for a decade despite the support of his loving family, the extraordinary stimulation of his work, his access to the best medical care and his high level of physical fitness. What’s needed are new medicines that attack the causes of the disease directly.

They're right, of course (said the self-interestedly enlightened, aging baby boomer). It's important to note, though, that the article elides Alzheimer's and the dementia that can result from the emotional isolation and discouragement that attend old age, especially in nursing homes. No family that chooses institutional care for an aging relative does so blithely, and none deserves to be judged. But a considerable number of folks who manifest depression-related dementia while living in unfamiliar surroundings -- as many as 50%, according to one study several years ago -- might perk up at home.