Livers for Life: Donate Yours Today

Agamedes points out that recent debate over liver transplants is misguided. It is not, "Should this person get a new liver?" The correct question is, "Which person will you sentence to a certain death?"
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On Friday 26 February, the Editorial in The West missed an important point. The Editorial describes the impossibility of taking the emotion out of "a decision ... when the alternatives are giving ... a chance of a future and consigning her to a likely death". The "decision" is to not put a person on the waiting list for a second liver transplant.

The particular person is either "a 24-year-old mother of two small children" or "a heroin addict" -- depending on which emotional strings you wish to pluck. In truth, of course, Claire Murray is (or has been) both.

Do you need new -- lateral -- thinking for your own problems? email nick leth at gmail dot com. Need solutions? No worries. Now.

As an aside, let's look at my previous paragraph. Claire Murray is or has been a mother of two small children? Well, how small is "small"? We make them small children in order to elicit more sympathy. A mother of two great hulking teenage brutes would have less emotional impact. And she is or has been a heroin addict: she has been "clean" for eight weeks. Eight weeks? Is that "clean" or is it simply a minor delay in the supply chain...

"Heroin addict" has pushed Murray off the waiting list for a third liver. (The first was her own, the second she destroyed by use of heroin.) "Mother" and "clean" are emotional attempts to get her back on the list.

The actual decision

The decision is not, Should Murray get a liver? The actual decision is, Who shall we kill in order to give Murray a chance at life?

There is a limited supply of donor livers. If Murray gets one of that limited supply then she gets another chance at life. The decision will also condemn another person to a definite death.

It is not a choice of liver or no liver. The true choice is, Who shall we condemn to death?

The correct corrective action

Everyone: Sign up today to allow your liver to be donated! Tell your family, let it go, I want to donate. Encourage all of your family -- and friends, and casual acquaintances -- to allow liver donation. What we want, is enough livers to satisfy the entire demand.

Sure, some people may go through a liver a day. If we have livers to spare, who cares! Sure there is a limited number of surgeons to do the work. While we're waiting for the potential donors to die -- we can train up some specialists.

The key limitation is the supply of donor livers. Today is the day that we can act to -- eventually -- remove that limitation.

And now... back to reality

Australians are, it seems, reluctant to donate livers. So there is a shortage of donor livers. How do we deal with that shortage? How do we decide who gets on the waiting list?

No, sorry, that's the wrong question. Or, rather, we can simplify the problem by asking a better question:

• How can we prioritise the people on the list to be liver recipients?

Being put on a list means nothing -- except some minor assurance that someone cares. Being off the list means death. Being on the list means that there is, at least, some hope. If there is a sudden surfeit of donor livers -- you are in with a chance.

We still have two problems: (1) There is a shortage of donor livers, and (2) different people offer different chances of putting a new liver to good use. All that means is, that we need (or want) to put some people nearer the top of the list. So do it!

1. Put every potential liver recipient on a list for a possible future liver transplant.
   
2. Separate them by blood type -- or whatever it is that determines compatibility with a donor liver. It's no use fighting over a liver which is not compatible with your body; each liver "type" may as well have its own waiting list.
   
3. Each person on each list gets a score out of 100, based on the current transplant criteria. For example: has been drug addict, minus 50 points; is now "clean", one point per clean week; lives with supportive parents, plus three points...
   
4. Do the current criteria include factors such as time on the waiting list? If not, add a few points for each month on the waiting list... More bonus points for those who are closer to death... Extra points for "cute", or "per child under ten", or "donates to charity"... or whatever criteria are acceptable, measurable and agreed.
   
5. A liver becomes available. Check the list for this "type" of liver. Whoever is at the top -- of the relevant list -- gets it.
   

The choice is not, this person can or can not have a liver. The true choice is, if we give this person a chance at life then this other person is condemned to death. It would be nice to give everyone a chance at life -- but there is a shortage of resources; there are too few donor livers to help everyone.

But everyone can be on a list; everyone can have hope.

Oh, and if you are convicted of murdering all the people ahead of you on the list: that's 100 points off your score. But there is still hope... Because, after all, everyone deserves to have some hope.

Independent thinking & independent analysis of your problems by Agamedes Consulting. Support for your thought: email nick leth at gmail dot com