Organ Transplants for Smokers

Today in one of my tutes we were discussing organ donation. There are never enough organs to give to everyone who needs them, so doctors often have to choose who to give them to. One of the issues that we were dealing with is whether smokers should be given organs when there are other people who have developed conditions through no fault of their own. There is a medical reason for not giving smokers organs, as they are less likely to recover from the operation than non-smokers. However this is not the only issue. Many people think that smokers should not be given the organs because they have brought their illness upon themselves and should therefore have to deal with the consequences.

At the moment, doctors discriminate against smokers when choosing who to give transplants to. Smokers go to the bottom of the waiting list. What do you guys think about this?


Submitted by nemesis on Fri 11/04/2003 - 21:05

All forms of discrimination sucks. Discrimination forms a divide in society, and brings about things like elitism.

When deciding who an organ goes to, it should go to the person who needs it the most, not decided on the grounds on whether the doctor believes they deserve it or not.

Submitted by alpha on Sat 12/04/2003 - 10:09

i agree that discrimination of any kind sucks, and that who gets an organ should not be decided through who the doctor thinks deserves it most.

However there is a point that smokers knew the risks entirely when they decided to start smoking (exceptions for older generations, yet they still know now and can quit), and that they were not forced to start.

Also the point that a smoker is less likely to survive the operation than a non-smoker is a valid one - if the person the organ is given to dies soon after being given the organ then the organ was essentially wasted and more people will die as a result.

i think that basically, if the person in need of the organ is STILL smoking whilst being put onto the waiting list, then they should face the consequences and not be put as high on the list as they would have had they been a non-smoker.

I really don't know what should be done about smokers who have quit.

Basically, smokers are warned that smoking kills - and they should deal with that fact.

and I disagree that discriminating against smokers in organ lists forms divide in our society and brings baout elitism. Smokers chose to smoke, they did have a choice, so it is not a form of elitism at all, elitism is cutting off people who have a natural disability, or simply aren't as good at something naturally - through no choice nor fault of their own. This is an entirely different situation and cannot even be compared.

Submitted by Wuji on Sun 13/04/2003 - 16:50

I pretty much agree with you there. In my opinion, the organ should be given to whoever will benefit most from it. For example if a smoker's life expectancy were increased by 6 years following a transplant and a non-smoker's by 3 years, I think it would be correct to give it to the smoker.

In the situation where the non-smoker and smoker would both benefit equally from the organ, lots of people would argue that the non-smoker should have the transplant seeing as their condition is of no fault of their own. The smoker's health would continue to deteriorate if she/he continued to smoke following the transplant, so it might be less beneficial to her/him in the long run. Do you think the non-smoker should get the organ in this situation?

Another consequence of discriminating against smokers is that people from low socio-economic backgrounds (who are possibly more likely to be smokers) are discriminated against at the same time. Though there are plenty of people from high socio-economic backgrounds who smoke, it is possibly less common in this group and also, these people can generally afford private health insurance and so are more likely to have good health treatment than the others. For this reason giving preferential treatment to non-smokers could be viewed as yet another way to discriminate against the poor and lead to further deterioration of their health situation .

Submitted by nemesis on Sun 13/04/2003 - 22:54

Does passive smoking count in your discrimination?
If a barman develops lung cancer and requires a new lung, would you discriminate against him if there was another person who required the lung as well?

And if the barman were to continue working at his bar even after the transplant?

Submitted by Wuji on Mon 14/04/2003 - 14:57

I'm not sure whose discrimination you're referring to by "your discrimination" but I might mention at this point in time that I have not said that I would discriminate against smokers.

As for the barman, I imagine that if he were to continue working at his bar after the operation and that would mean that he would benefit less from the organ than someone else then he would be treated after people who have a better chance of recovery. If this were the decision that was made, it would be a decision based on medical rather than moral reasoning. Which, in my view, is how it should be. The organ should go to the person who would most benefit from it.

Presumably, seeing as we live in a very litigious world, the barman would sue his work and would receive a substantial amount of money. For this reason he would not have to continue his work at the bar following the organ transplant so in actual fact, smoking would not inhibit his recovery.

Submitted by Husk on Tue 22/04/2003 - 12:31

It all comes down to who has the money:
A rich smoker will always get first preference.
Thats the way things work in this modern world.

Submitted by nemesis on Tue 22/04/2003 - 12:41

Can't wait till I'm rich....
The things I could do..
The integras I could buy...