Politics and organ transplants

Not based on need: Congress protects small transplant centers at expense of sickest patients.

April 17, 2000

POLITICS rather than good [medicine lies at the heart of a bitter dispute over distrib-uting scarce human organs. People are dying, unnecessarily, as a result.

Small hospitals with lucrative trans~plant programs have per-suaded Republicans in Congress to protect their self-interests. This means, the sickest patients await-ing organ transplants don't receive the available organs. It also means that the hospitals with the highest success rates -- in urban centers --are denied donated organs.

From a medical standpoint, it's appalling. Politics has won out over saving lives. Earlier this month the House of Representa-tives approved a bill that would perpetuate this tragedy by ensuring that hospitals in small states control the distribution of donated organs. The nation's best transplant hospitals, and the country sickest patients, would suffer.

Republicans want to strip the federal government of its power to oversee organ distributions. Yet a study by the respected Institute of Medicine last year endorsed fed-eral intervention. As the panel's chairman put it, a federal role is essential to see "that the system is equitable, is grounded on sound medical science and always places the highest priority on the needs of the patients it serves."

Who can disagree with those sentiments? Republicans from smaller states, where local doctors are worried about losing trans-plant business to successful urban hospitals such as Johns Hopkins and the University of Maryland.

The current setup is absurd. It reached the point last year that the private contractor running the or-gan program -- dominated by small-state board members --threatened to punish the Maryland hospitals for their success: They were using too many out-of-state organs as patients clamored to get into Maryland's two nationally prominent transplant centers.

Fortunately, the House-passed bill doesn't have enough support to withstand a promised veto from President Clinton. Instead, new federal regulations are forcing the private contractor to develop a plan for distributing organs based on urgency instead of geography.

The regulations only took effect in mid-March. The private con-tractor has been cooperative so far. Let's hope it continues -- and that Congress comes to its senses and lets medical judgments, not self~in-terested politics, decide who re-ceives these precious gifts ot life.

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