by richard bellis

chosen patients

A 17 year old woman takes a paracetamol overdose after a row with her boyfriend. It is the first time she has done this. Without the transplant she will be dead in 4 days

A 35 year old unemployed man lives alone. His liver disease will kill him within 9 months unless he receives a transplant

A 9 month old boy has liver disease. Without a transplant he will die in 18 months. He has three older brothers and one older sister

A 68 year old woman looks after her 92 year old father at home. She has a serious liver disease and will die within 6 months without the transplant

Note down the following in your notes:

1. Why did you select the patients that you did?

different reasons for each but mostly because the majority did not cause their position knowingly and some patients they did have the youngest age categories coupled with the greatest survival % after

1. Which criteria did you choose and why?

Outcome of transplant—patients likely to live longest after transplant will get priority

Drugs—patients whose liver disease is unrelated to an overdose or taking illegal drugs would receive a higher priority than those whose liver disease is related to drug abuse.

Alcohol consumption—patients whose liver disease is unrelated to alcohol would be a higher priority than those who have alcohol related liver disease

Work status—those who are likely to return to paid work or caring for family after transplant would get priority

1. How did your own selection vary from the results in the study?

2. It appears that professionals and the public may have a different approach to prioritisation and yet the health service is funded by the taxpayer. Who is right in your opinion?