I thought this was about kidneys instead of livers and was very confused.
My cousin was a raging alcoholic. He got clean, but not before he fucked his liver right up. I don’t know if they even allowed him on the liver transplant list or not, but if he was, he was very low on it. He died in early 2015 at the age of 43.
How long was he drinking? And how much?
The provincial governments in charge of our single payor health care system made the conscious decision to keep the liquor marts open while banning in-person sales of tea kettles (and we call ourselves a commonwealth nation!) during a pandemic.
I think our single payor at least partially did this to themselves.
I’m pretty sure people would’ve stormed parliament if you banned alcohol sales.
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it’s* their fault
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Jesus Christ that’s fucked up. Only 36 too and stopped drinking… and had a willing living donor. What do you do in this situation when they won’t help you? Go down to Mexico?
I was reading through the article and I think the policy in question is this
Transplant guidelines in Ontario and much of Canada require patients with ALD to first qualify for a deceased donor liver. If they don’t meet that criteria, they aren’t considered for a living liver transplant, even if one is available.
Also this
“The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor,” said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
As for why that is, I’m not familiar. I’ve asked someone else and I’ll edit in more if I learn more
Jesus Christ that’s fucked up. Only 36 too and stopped drinking…
From the article:
Amanda Huska died Aug. 15 after spending six months in an Oakville, Ont. hospital.
and:
Huska, he said, stopped drinking as soon as she was diagnosed with Alcohol Liver Disease on March 3
So that sounds like she was immediately admitted (which implies she was already very sick) and only was sober in the hospital. In my opinion, that doesn’t qualify for “stopped drinking” and unfortunately she didn’t get a chance to prove whether or not she was actually able to stop.
How much do you need to drink to get ALD at 36?
Typically, a huge amount. But genetics may have been an issue, as well.
It seems the average in the US is 10 years. But you can develop it and reach critical levels in as little as 5 years. Hard alcohol every day. Multiple times a day.
Jesus…
And why the fuck is alcohol taxed so damn high then? I thought that was the compromise.
It’s taxed the way it is, because the only drug that kills more than booze are cigarettes.
Those taxes also go to help innocent people who are harmed in crimes that are often related to alcohol, like domestic violence, assault, and auto-incidents, also things like uttering threats and mischief.
domestic violence, assault, and auto-incidents, also things like uttering threats and mischief.
Crimes most committed by the police?
I agree with the general vibe of police are bad, in Winnipeg they recently killed a woman because they were driving off-road in a park at night, but the idea behind “sin taxes” are generally as a deterrent, as well as a way to try to mitigate damage to others.
I’ve been to places that are “cop bars” unknowingly, so the porcine populace may have have a DV-juice problem.
Fair point
Partial transplant from a living donor was not viable for her. It would have immediately failed, leaving her with no liver at all, and then she would have died because she wasn’t eligible for a full transplant. Doctors will not perform a procedure that guarantees death. The article explains this
I read the whole article and never saw that
But doctors say that people with severe liver disease from alcohol use may need more than just a partial living liver donation to thrive.
“The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor,” said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
Guy you were responding to wasn’t entirely accurate with what the article says, but general idea is there. If the partial liver fails, then they immediately get added to the full liver list, which is why they need to meet the full liver list requirements. Based on how end-stage she was, it sounds like its less likely the partial would be successful.
Well, stopped drinking when she got the diagnosis, not before, relapsed into drinking while on the transplant list, and as they said in the article there are a lot of criteria for a living donation, and it’s only an option if you otherwise qualify for a donation because of the possibility of rejection requiring an urgent transplant.
A different article said they were trying to raise funds to get the transplant done at an unspecified European hospital, so “yes”. I think it’s telling that they didn’t go to the US, a north American country, or specify the country.
It’s worth remembering that the only people who can talk freely are the people who were decided against and are talking about suing.No one wanted her to die, but with organ transplants it’s a case where you’re more or less picking who will die. Phrasing it as being punished for bad behavior is unfair to the people who need to decide which people are likely enough to benefit, which isn’t easy.
it’s only an option if you otherwise qualify for a donation because of the possibility of rejection requiring an urgent transplant.
why not remove that rule in those cases instead of condemning the patient?
Because, it’s a risk-reward calculation. If the patient doesn’t qualify for transplant, then the expected risk outweighs the expected reward. In this case, the risk isn’t just to the patient, but also the donor, and by extension, the medical system itself.
I believe this is FALSE:
[she] relapsed into drinking while on the transplant list,
Where does it say this? I reread it 3 times. That’s a huge part of the story and not one you should just make up!
Not made up, I just read a couple other articles that mentioned it.
It’s also part of the whole “the only people who can talk freely are the people with an interest in the doctors being wrong”.People aren’t turned away because they didn’t exercise or because they work too much or they don’t get enough sleep or they didn’t follow doctor’s orders. So, in Nathan and Amanda’s case, you’re seeing someone being told, ‘You didn’t follow doctor’s orders, so we’re not going to help you. We’re going to let you die’
As a quote from the other interested party, as well as the “in documents shared with CTV News, notes show […] their decision was based on ‘minimal abstinence outside of hospital.’” is pretty much spelling it out.
‘minimal abstinence outside of hospital.’”
I’m not sure why folks seem to think ‘minimal abstinence outside of hospital’ is a smoking gun. That’s pretty much how medical staff should document an alcoholic whose sobriety only began while hospitalized. It means she hasn’t been able to quit drinking!
In isolation it’s not great, but in conjunction with your own advocate talking about you not following a doctor’s orders? It doesn’t bolster confidence that the individual would follow doctors orders in the future.
It means she hasn’t been able to quit drinking!
Yes, that’s exactly the point. It’s quite unlikely her medical troubles started when she was hospitalized.
A history of not following medical advice casts doubt about a future of following medical advice.Yes, addiction is a disease that the individual may lack the ability to control. That doesn’t change that it’s a risk factor for non-compliance that’s absent in others who need the transplant.
whoa wait a minute. I didn’t realize which comment i was replying to. I read three different articles and found NOTHING stating she relapsed.
I do similar documentation and I can promise you that “minimal abstinence outside the hospital” does NOT mean relapse.
I’m gonna have to ask to see the citation or ask you to delete your comment for misinfo
I re-traced my steps, and the source was both dogshit, and didn’t site primary sources. I edited the original comment to convey non-compliance before hospitalization was required.
Ultimately “was sick, didn’t listen when doctors said to stop drinking” conveys the same doubts that “tried to stop but failed” does about suitability for a donor liver.
I didn’t catch the part where she relapsed after diagnosis. For fucks sake how much was this lady drinking to get liver failure at 38?
heavy drinking – a term defined as five or more drinks for males, or over four for females, on one occasion at least once per month in the past year.
What the article calls heavy drinking, would have been nothing to me when I was an active alcoholic. Towards the end I’d be drinking anywhere from a pint to a fifth of bourbon a day. I was an active alcoholic for over a decade, running from age 23-33. I’m thankful that I was able to sober up, celebrated 5 years sobriety (from alcohol) a few months ago. Saved my life.
Congratulations! My wife drinks a ton and has since high school. I make her get blood work done regularly and the worst that happens is inflamed liver.
She drinks like 3 of those boxes Costco wines a week so at least 2 bottles a day. Sometimes liquor on weekends. She just turned 40
If I were you I’d try to switch off to smoking weed instead. Much healthier, no hangovers, no adverse side effects, and so much cheaper! A chronically inflamed liver leads to some bad things, and dying from it is not pretty or gentle
Not a chronic weed smoker, but how does weed help? Does it fulfill the same need?
And isn’t this just trading lung health instead (and throat health, though I imagine alcohol isn’t great for your throat either)
It fulfills the same need of “something to mark a time of relaxation.” while being much less detrimental to your health. Low temperature vaping and edibles are as low-impact as you can get to your lungs. Additionally, even if you opt for actually “smoking” the flower, you’re only ever taking a few hits (or if you’re like me, on most nights just one!) so it’s exponentially less harmful than cigarette smoking.
I don’t drink more than twice a month. I do have an addiction to sparkling water however.
Maybe I can get my wife to switch though, I’ll try! Thanks for heads up.
It actually takes surprisingly little if it’s done consistently and without giving your body time to rest.
A standard drink has roughly 14g of ethanol in it. People with notable liver damage tend to have a history of a decade or more drinking 30-50 grams a day, or two to three drinks.
People who drink more than 80g a day for a decade are almost guaranteed to have liver problems (~5-6 drinks).Obviously drinking a half gallon a day is worse, but consistent long term drinking is also not great.
It is essentially a poison that’s only around because it’s easy to make and traditional at this point.
Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
I’ve come to the realization the only ones getting us off the dark timeline is us. I’m in USA, ready and willing. Thinking through what beginning steps I can take.
I didn’t like the cost section, because it felt simplistic. The actual procedure might be “cheaper”, but it doesn’t take into account the long term costs if something goes wrong with the “cheaper” option. Living liver donation is different from say a kidney, you’re taking a part of someone else’s liver.
“The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor,” said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
I worry people are going to see those numbers and run with them, even though there’s more to consider than that. Financial calculations in medicine are always difficult, and it feels dirty no matter what
The article is not clear. Is the $71k price listed the cost of the surgery itself or surgery + hospital stay?
If it is just surgery then it is a very unfair comparison since the ICU stay would have been needed in either case, and at least some of the days in the ward for recovery.
Plus living donation means the donatee needs recovery time and a bed as well.
So some rough numbers I found from places online for rough estimates. Also, the link the article has for bed costs is actually to a study on liver transplant costs.
On average, 25 days in hospital between pre/post transplant. Of that, seems like a few days (varies by person) is in ICU. So thats 50 days of beds for the two of them, with say a week of combined ICU time.
Plus two surgeries - the article only takes an average cost of liver transplants, which is not indicative of a second surgery needed for a living donor transplant.
That puts the cost up to ~240,000-300,000. That cost is close enough that I can see it not being a factor for the decision.
As grim as it might be, transplants are handled by apathetic, risk averse math and little else. Loose organs and surgeons are far from common.
Honestly I find that the opposite of grim, I wish more problems were solved in a cold and calculated way.
Like killing disabled people because it’s cheaper, farming slaves to provide cheap labour, that sort of thing?
There a good reason we tend to prefer the more humane and emotionally guided solutions over the mathematically most efficient.
Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day
A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019. “It’s a shame that so much money was spent keeping her alive under such horrendous circumstances and putting her family and her partner under such stress when the remedy was a lot cheaper and could have happened much, much sooner,” said Selkirk.
The survival rate of patients with alcohol-related liver disease who receive a deceased donor liver transplant has steadily improved to reach 80–85 per cent at one year after a transplant.
Can anyone make this add up?
I’m quite torn on this issue, my sister donated her kidneys and liver when she died. On one hand people who need an organ, need an organ but on the other hand deceased persons organs are so rare that they should go to those with liver diseases they have no medical control over before those who are sick from an avoidable disorder.
I don’t like to think of my sister’s liver going to someone who would abuse it over someone who just happen to have a genetic liver issue. She lived a life too short bringing joy and education to many children, her final act saving others would be soured by someone wasting it.
I guess you can also think of alcoholism as a disease too?
Some could consider it a mental disorder.
Compared to an autoimmune disease that attacks organs and glands, I’d think the autoimmune patient should be top of the list. Probably good that I’m not on death panels though.
It is, or at the very least is a symptom of another one. I have all kinds of addiction issues which is why I must be super careful in my life. I am a former alcoholic who used to drink nearly every day from basically after work until I was too tired to keep going. I also have ADHD and possibly ASD (the latter not officially diagnosed as of now). There seems to be some evidence that those can play a role in addiction.
I completely agree that alcoholism is a disease, and as with any other disease, we have to look at the survivability if she got the transplant.
Let’s be honest, while the article tries to be favourable to the patient, you can piece together the facts and see that her odds weren’t good. While she’s been sober since she got the diagnosis, it appears she was immediately hospitalised which tells us she was in very rough shape and has only been sober while in the hospital. Even if she was able to stay sober, it looks like the odds with a partial transplant aren’t great.
There are more people who need transplants than there are organs, so the medical profession has to make decisions about who to deny. This was a reasonable decision, in my opinion.
In Canada, drinking more than 3 drinks per week is medically considered “high alcohol use” for a woman… (6 for a man). This limit keeps getting lower year after year
If this can prevent you from getting organ transplants, then it encourages lying to your medical doctor about your current habits… That lady was not considered alcoholic, she just used alcohol in greater amount than the limit considered acceptable by doctors.
Latest stats show that almost 4 out of 5 people has exceeds that limit at some point in their life. This woman died only because she was honest with her doctor about her alcohol use. (Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol. It’s not about lacking donors.)
That’s total bullshit. As a IT professional I have a nightly drink after work for self medication. Never two. Just one.
I’m guessing you can stop at any time if you want to? I’ve known older healthcare professionals that have approved and even encouraged one drink a night, but our understanding of the effects of drinking has evolved. I doubt doctors keeping up with the science would encourage it at this point. It would be like having someone come in that’s overweight. It doesn’t mean you’re unhealthy now, but it may be a factor that needs to be kept in check and working on it could prevent issues in the future.
Yes I can and have stopped. I drink 2-5 times a week and it’s one 40 proof 1oz (not a shot 1.5oz) over rocks with a bit of soda. Same or less than a beer.
This isn’t two shots neat daily or a six pack of beer. Sometimes I go a week without. Other times it’s 5 times a week.
Just do what I do and put it in that deep cupboard above the fridge. Then forget about it for literal years by mistake. It’s doing wonders for my health. Just wish I could do a version of that for my bad sleep schedule.
Just remember if a doctor ever asks then lie and say only on friday, there’s a few things in life you absolutely have to lie about because the system is not designed to care about people.
Here in the uk never admit to smoking weed to a medical professional, never admit to even so much as thinking about any form of self harm, delusions, emotional regulation issues… it can come back decades later and fuck you over.
Wait what happens if you admit to smoking weed? I thought we had doctor patient confidentiality. I’ve had some mental issues in the past, though not to the point of self harm. What happens if I admit these? I also live in the UK and this is concerning.
This is generally pretty bad advice.
I mean I get where you’re coming from, and I cannot speak to what it is like in the UK (I can only speak as a man in the US), but you should not lie to your doctor.
If you see a doctor, and they start treating you differently after finding out that you smoke weed, then you find another doctor.
Unless you’re in Canada and there’s a doctor shortage and you can’t just shop around for a different family doctor if you don’t like your current one. If you’re lucky enough to even have a doctor here…
The only genuine hint to the real reason of the refusal was “minimal abstinence outside of hospital”.
Let me ask you bud, if you needed a liver transplant to continue living, would you have even one drink per week, or would you just quit completely?
Very biased article.
Plus, regardless of her husband being compatible, it still costs the state tens of thousands for the operation. In no way would it be ethical to put a new liver in someone who refuses to completely abstain from alcohol.
That’s absurd. Refusing someone a transplant because they used to drink more than 3 drinks a week before they knew they even had liver problems is completely absurd. Calling her an alcoholic for that is even more absurd. What in the world are these people or you thinking?
“minimal abstinence outside of hospital”. That means she was still drinking.
Are you on purpose missing the point?
The point the person you replied to made is that she didn’t completely stop drinking alcohol once she was diagnosed to have a terminal liver disease due to alcohol use.
So first of all, she must have drank a lot more than 3 drinks a week to have terminal liver disease in her 30s that’s due to alcohol (yes, all of that is in the article)
But the issue is she didn’t stop drinking after being diagnosed, she reduced her consumption but didn’t stop it.
If any of the above is incorrect, feel free to correct us, but making a point that’s completely missing the facts that are being talked about here doesn’t add anything to the discussion.
The first point is correct. The second one is shown to be wrong in the second paragraph.
The issue here is you need to have stopped 6 months or more before, and she was only diagnosed 5 months before she died.
This woman died only because she was honest with her doctor about her alcohol use
No, and it even says so in the article
She quit about 5 months before her death when transplants require 6-12 months of sobriety. She was drinking regularly with the fucked up liver before that diagnosis, and liver damage isn’t something that just suddenly appears.
She kept drinking despite what would have been intense cramping pain and a slow death, thats why she was denied (addiction) and ultimately died
Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol
And as the article also says it’s incredibly dangerous for someone to get a live-donor transplant when they’re in bad shape like she was, as failure of that means they’ll need to let her die on-table or transplant a good dead one into her (which she was denied for, due to her drinking)
It’s sad, but this woman died to alcohol abuse, pure and simple
That’s a lot of vague statements you’ve repeated from the article. What’s drinking “regularly” (this was before the diagnosis as you’ve stated)? “She kept drinking”, what does that mean? How much alcohol was she consuming? Did she have a sip of her friends wine and was honest about it so was rejected?
as the article also says it’s incredibly dangerous for someone to get a live-donor transplant when they’re in bad shape like she was, as failure of that means they’ll need to let her die on-table or transplant a good dead one into her
Where does it say that? You’ve completely twisted the statements.
“On the off chance their (living) liver doesn’t work, they urgently get listed for a deceased donor,” said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day, A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
In 2021, 15.6 per cent of Canadians over 12 engaged in heavy drinking – a term defined as five or more drinks for males, or over four for females, on one occasion at least once per month in the past year.
Heavy drinking is drinking ONCE per month in the past year. If this is based off of before her diagnosis, you’re gonna exclude like 80% of the working population who actually does go out for drinks or private occasions (unless they just lie which I guess they should’ve in this situation). Between the price of keeping them alive but not fixing the problem and there being no “review” process for decisions, I would categorize this as a bad system that allowed a preventable death from an alcohol related disease to continue.
I’d be inclined to agree, except that her partner wanted to donate HIS liver and was prohibited from doing so as a living donation due to the alcohol use determination.
Maybe if donating organs was compulsory they wouldn’t be so rare.
They still need to be a match
Imagine how many matching organs are just left to rot in the ground.
Can’t just implant a 90 year old liver. And a lot of them are unsalvageable. Doesn’t mean it shouldn’t be mandatory, just that it will still be a limited resource.
I don’t want to be morbid, but with as many gun deaths as there are in the US there are lots of young livers to go around.
God, the custom tailored ideal American healthcare system, you’re right but I hate it lol
Once again. There is more than the USA out there…
I think the US can supply surplus to its neighbors.
In my country, people are automatically registered as a donor. If you don’t want to donate, you have to choose to opt out.
Ever since that law was passed, I see organ transport ambulances around my city’s hospital from time to time. Transporting a matching organ to a waiting patient. The bold letters spelling “organ transport” on a red band is a weird but good thing to see.
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Do you mean opt in by default?
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Why not? Why do you need the ability to deprive someone of a live saving procedure after you literally died?
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I see, that’s a valid concern. I wonder whether we could try to prevent such abuse by automatically excluding more prone groups like prisoners. It really seems crazy to me how many organs, which could literally save someone’s life, are going to waste.
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In my country, everyone is an organ donor unless they specifically opt out. Usually due to religion.
I’ve been seeing organ transportation ambulances near my city’s hospital from time to time. It’s weird to see, but a good thing.
There should be no opt out, even for religion. No I do not respect your customs as much as I respect someone else’s life.
I agree. I think people who choose to opt out for selfish reasons should be placed lower on the list. It’s inmensely hypocritical.
As an alcoholic, I initially agreed. Don’t waste a liver on me. Then this:
Even pleas for a living liver transplant, with Allan offering to be her donor, were not entertained.
What the actual fuck.
A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor, or she would die in operation.
Since she wasn’t eligible, a partial transplant was just a death sentence.
They said it was viable in the early stages, and with a decent success rate. Just not the success rate they wanted, and for some daft reasons you need to be eligible for a full transplant from a dead patient to get a partial transplant from a living donor. Makes no sense.
Liver failure is terminal. She was invariably going to die without the transplant. She wanted to receive the donation, her donor wanted to donate. If the success rate for a living transplant is zero that’s one thing, but that’s not being claimed here since she wasn’t eligible for procedural reasons.
It’s not like giving away part of your liver is a zero sum game, now that person is at risk of infection, has lesser liver performance, and for what? Someone who has showed they will just continue to harm themselves, and others (the person they’re getting the liver from,) if you allow it?
I don’t know any other surgeons who would do that.
Has lesser liver performance? What? Do you understand how a living transplant works? You both regrow a full liver after the procedure, because livers are so regenerative you can make a full one from less than half. This makes no sense to me.
Also she quit for 5 months after she found out she had liver failure.
It takes years for a donor’s remaining liver to grow back, and the recipient is unlikely to grow out more of the donated liver depending on comorbidities and severity of illness.
If a surgeon refused to let me save the life of the one person in the world i love then they wouldn’t be able to save any more lives after that so add that to your heartless calculations…
There are very few transplant surgeons who would take the risk of a partial liver transplant which they have high likelihood of being a death sentence for the patient (not sure if you read but they need a full liver, from a cadaver, not partial,) and want to willingly throw their name in with another patient to discuss during M&M.
This is coming directly from familiarity with the procedure, comorbidities, and other factors from a general surgeon at a top 10 hospital in the US.
Yes these people should indeed be killed for letting another human die for no good reason.
Takes up valuable hospital times
No. A partial liver transplant wasn’t viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor. But she wasn’t eligible, so a partial transplant was just a death sentence.
I’d have supported her paying out of pocket to use the live donor that was willing, but not to use my tax money when it’s pretty fucking clear she has no intention of changing.
It’s the same reason I’m largely against the Liberal’s diabetes funding - ~90% of diabetics are Type 2 (I’m willing to help Type 1’s out because it’s not their fault) and the vast, vast majority of those are from unhealthy lifestyle even if they are genetically predisposed.
If were going to have a public health system, people should be required to take care of themselves. And no, I’m not talking about the one-off accidents from riskier activities (although I do think people should bear the cost of their own healthcare if it’s the result of criminal activities), I’m taking the problems that occur as a result of abusing your body for years or decades.
So I drink more pop than I should. Why should I have to pay more for my healthcare than my buddy who had a habit of timing running green lights as soon as they turned green. That isn’t illegal, either, yet it’s very risky behavior. It didn’t work out for him just one time, and he nearly died. Why should taxpayers have to pay for him?
The answer is because the vast majority of us engage in risky behavior, or just have the bad taste of passing on our poor genetics to the next generation, and the social cost for penalizing people for not agreeing with societal norms are too high. This includes drug use, even legal ones like alcohol. Sure, don’t spend limited resources such as donated livers on people who aren’t willing to make the lifestyle changes required to make it worthwhile, because someone else will probably have to die for that to happen. But if we could make new livers and the price was reasonable, I wouldn’t even be against that.
If your buddy who likes gambling with green lights was convicted of a traffic offence as part of that accident he should have been on the hook for his own healthcare and the healthcare of anyone else he hurt.
Way to miss the point. It’s a good thing you don’t engage in any risky behavior, or anything that would have a negative impact on your health. I mean, it’s not like you would be a hypocrite, right?
I never said “Don’t engage in any risky behaviour”. Stuff like cardiovascular and lung diseases and Type 2 Diabetes doesn’t happen over the course of days, weeks, or months, you have to be chronically treating yourself like crap for years to get to those points.
Free climbers don’t usually die the first time, either.
You should pay for their healthcare, because you have a contract with an insurance company.
What makes you think that I, posting in a Canadian community about a Canadian article, have a contract with a healthcare insurance company?
oh, sorry, there was much talk about public health insurance, i Of course don’t have a clue how that works in canada. sorry, my fault. I only focused on public health care, here in germany thats an insurance, i was ignorant.
Not a problem. It’s essentially rolled into our taxes for the most part in Canada. You may have health insurance on top of that, but that isn’t a guarantee and usually is a top-up of our universal coverage. This usually covers things like drug prescriptions, glasses, and hospital conveniences such as semi-private or private rooms. I agree with the general idea, though, that we as a group pay for everyone who is covered. My original point at the top of this thread is that removing people’s eligibility simply because of risky behavior can be very tricky and likely harmful to society.
You’ve gotten a lot of downvotes but rather than doing that I want to explain to you why your position here is flawed.
First think of every lifestyle activity whether it be food, motorcycle riding, music, etc. Now consider that there are some activities that are statistically safer than others.
If we took your position to the point of being law why would we stop at food lifestyle choices? Why not just any risky lifestyle choices? Eventually you end up with a society where individuals have less choice and freedom and are constantly obligated to live the safest possible lives.
You and I both know that isn’t a desirable outcome. We should be empowering people to live the lives they choose and encouraging them to be healthy, not punishing them for make the “wrong” choice.
I attempted to address this but perhaps I wasn’t clear:
Yes, some activities are risky then others, however many of them have absolutely 0 negative impact on you unless something major happens all at once. In fact, many of them have major health benefits for the vast, vast majority of participants.
Contrast the above to overeating, chronically eating stuff that’s not good for you (ex. excessive sugar, salt), drinking too much, doing lots of drugs, smoking… that kind of behaviour will basically screw up everyone who partakes given enough time and has no positive health benefits at all.
You talk about a loss of freedom… I’ve already lost freedom by paying for a bunch of people who purposely fuck themselves up for no tangible benefit to themselves. There is stuff that would be good for me that I literally can’t afford because of the amount of taxes I pay.
Here’s an idea for your route of encouraging healthy lifestyle rather than removing freedom: include a physician form in my taxes where my doctor attests that I am generally in good shape (given my age) and he has no reason to believe I am doing anything that is a risk factor for chronic cardiovascular or lung diseases, diabetes or related chronic illnesses, and give me a significant tax break for doing so.
Consider what you just said can apply to motorcycling or buying a classic car with outdated safety features. There is no tangible health benefit to motorcycling or driving a classic car, it basically “has no positive health benefits at all” (as per your own words) and only increases risk. Show it be banned? What about every other risky hobby? If not, then neither should eating junk food which is measurably less dangerous/risky. Keep in mind that for smoking the overall trends of diminishing smoking habits in younger generations basically highlights the proof that encouraging healthy habits rather than punishing the individual is the correct way to approach this.
Buying a motorcycle or classic car doesn’t necessarily lead to injury in the same way that overeating and being lazy to the point of becoming a land whale does.
I suggest you look up just how often motorcycle injuries/deaths happen. What you’re saying only applies if you never get into an accident or fall off the bike ever, in the entire period it is owned (which could be 20-30 years). Something which is incredibly unlikely. From the language you’re using (i.e whale) I’m getting the impression that your position isn’t rational and instead based on a dislike of overweight people. I’ve done what I can here but I don’t think you’re messaging back in good faith and don’t want to entertain the perspective of someone who tries to put others beneath them based on their body and eating habits.
I’d be willing to bet that the number proportion of motorcycle owners with health problems caused by riding is a hell of a lot lower than the proportion of people who don’t eat right and don’t exercise enough and have health problems linked to that.
And no, it’s not just overweight people I don’t like, it’s also people that are sick all the time (like, weak immune coughs and colds type of stuff).
Being a judgmental asshole increases your likelihood of being assaulted. I shouldn’t have to pay your medical bills when you get punched in the face by a stranger.
Free expression bud, it’s my right to be a judgemental asshole. Take that up with Pierre Trudeau.
Right now you’re on the internet instead of being physically active, that’s a health risk.
Who says I haven’t already gotten enough exercise today?
You’re aware of the concept of overworking your body, right?
Who says how much it’s acceptable to eat or drink?
I don’t care if you’ve gotten enough exercise, you would be healthier if you were walking around the block right now instead of sitting inside on the internet. Since my taxes pay for your medical bills I get to tell you how to live your life, so get walking!
come on guys, step over your ego.
Great, so maybe you can stop paying for my healthcare and I can stop paying for yours.
What a shitty attitude.
Thats a dark road to tread.
An example,
no alchol consumption is safe, so using your line of thinking you’d need to argue that anyone who partakes of alcohol at any anytime would fall under that line of thinking
Processed red meats simailary, especially those treated with nitrites, so those eating bacon, ham etc shouldn’t be entitled to public heath care under your reasoning
Or are those things ok becase you do them ?
On the upside, now you’ve excluded 95% of the population, public healthcare will be cheap :)
Contra to most peoples thinking, if you’re concerned about public healthcare costs, you should “encourage” obesiety and smoking, they all die early, most health care coats are associated with healthy people in their old age. See here
https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html
Adults are stupid and greedy, we all are.
Perfect, let’s just get rid of public healthcare then
Threads like this always bring out the uninformed. It’s great. Easy to block them. Fish in a barrel.
it does not cost the state A DIME, because it is insurance that covers healthcare, not taxes.
The loss is unrealized potential of those who are sick. so, that means the state invested like 150.000 bucks in one citizen, in hopes to get like one million bucks out of them
(not out of them specifically, but out of their labour; it is a chain, you see, and the labourer pays taxes, the factory pays taxes when selling the product, the consumer pays taxes when buying the product, and so on)
alcohol and obesity by diabetis harm EVERY cell in your body, period. thats hard biochemstry, facts, it is the truth.
red meat, on the other hand, is quite unclear.
the studies involving red meat are interesting;
people self report by remembering long periods of time, a salami pizza counts as red meat, as does a whole mc donalds burger with fries on the side.
as for nitrate, this gets complicating. you seem to be on the right path. nitrates are a new topic for me, i never before read up on them:
https://www.diagnosisdiet.com/assets/images/5/nitrate-content-45165560.png
https://www.bbc.com/future/article/20190311-what-are-nitrates-in-food-side-effects
this is so tedious, no wonder everybody has a different oppinion
If were going to have a public health system, people should be required to take care of themselves
On the face of it, this sounds sensible. But, thinking more deeply, who should decide the required amount of care a person ought to take? Ideas about what it means to ‘take care of yourself’ are varied. And consider that some citizens of this country are simply unable to take the same personal health decisions that others have the privilege to take without a second thought.
What you’re talking about here isn’t a public system. A healthcare system that only serves certain chosen people is not public in any meaningful sense.
A public healthcare system is imperfect on the whole, but on average, when funded and administered properly, is structured to apportion care based on need, instead of the profit motive. I think that’s worthwhile, and the right thing for a society to do from a moral standpoint.
no one bothers that it is THE PEOPLE that pay for their health insurance, not the state.
the state made insurance mandatory, thats the only thing it is guilty of.
Until there is a diet that has long term success for a majority of its users I don’t think this mindset is healthy or realistic.
“According to the latest weight-loss research, 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss.” source
If you are going to make alcohol consumption a bar to a liver transplant without making alcohol illegal you should all go fuck yourselves. You had a drink and you should die should not be a thing.
This isn’t what happened though. She was addicted to alcohol, per her partner, got diagnosed with needing a new liver, she immediately quit alcohol, and they denied her anyway even though quite a bit of time had passed while she was sober. I am unaware if her liver disease was because of the previous regular alcohol use. It wasn’t just 1 drink though.
Yes, organ donation is messed up. I met a girl dying in hospice once. She needed a new kidney. Genetic stuff, and then when she was 15 she tried to kill herself with Tylenol. She got her first transplant before the suicide attempt. She was denied a second one due to the suicide attempt itself. There are only so many organs in the world. She died in agony in hospice, young and covered in calcium deposits.
We punish substance use and mental health so harshly in this country. No one deserves the death penalty for previous substance use, especially for alcohol which is ancient af. It’s horrible she was denied when there was a liver already available.
It’s horrible she was denied when there was a liver already available.
Any full cadaver liver that could have gone to this woman didn’t get thrown into the garbage — it went to someone else who would have died without it.
As for the living donor liver her boyfriend offered, even though he was a match her level of liver failure likely meant that the partial liver her boyfriend could have donated wouldn’t have been successful. Living donors still need a liver for themselves, and we each only have one full liver — so the best they could have done is given her half a liver. Her condition was too poor for this to have a likely positive outcome, which was why this was also denied.
It sucks, but there aren’t enough donor livers for everyone who needs one. The cadaver liver she was denied however would have gone on to save the life of someone else you’re not hearing about in the press — someone else who may have died without it.
If the unfairness of it all upsets you that much, then make sure you’ve signed your organ donor card, and make sure your family members know and understand your desire to be an organ donor. And encourage the people you know to do the same. This is only a problem because there aren’t enough donor livers for everyone — when you have n livers, at best you can save n lives — and thus having a larger number of donor livers allows for more lives to be saved, with fewer qualifications.
It’s hard to say if she would have lived or not.
I think a bigger discussion about medical gatekeeping and bodily autonomy is warranted here
I have been an organ donor since my first driver’s license
We punish substance use and mental health so harshly in this country
It’s not punishment, any chronic illness will make someone ineligible for an organ transplant. It’s not saying it’s that person’s fault, it’s a situation of “2 people need this organ, which ever you choose the other will die in agony, one is more likely to live twice as long as the other.”
He was only offering the organ to the one person though
What does your second paragraph have to do with that?
From my limited knowledge organ donation criteria are horribly restrictive on a personal scale but unfortunately make sense on the macro scale. Organs are such a scarce resource that as I understand there’s no other option.
This girl’s death was undoubtedly a tragedy, but as fucked up it’s to say if she lived someone else would probably die in a similar agony. Was she treated fairly - I don’t know, can we make this system better - I unfortunately also don’t know.
One easy way would be to make organ donation opt out instead of opt in. As in, if you do nothing, you’re an organ donor if you end up brain-dead, and if you don’t want to, you have to explicitly opt out. Alternatively, we could just say any brain-dead person may have their organs harvested, regardless of what they declared while still alive. After all, you don’t need the organs anymore once you’re brain-dead. (I’m specifying brain-dead, because if you’re completely dead, then the organs are also useless)
That would help to some extent with scarcity in opt-in countries. But there are already opt-out countries which still face the same dilemma. Because if you’re even one organ short how do you fairly decide who’s gonna die… Can you even fairly decide about someone’s life and death…
Organ donation panels are a sick Trolley problem come to life. I don’t know either.
Since no one has mentioned it, USA has the same policy basically.
Wait, so if someone was ever an alcoholic - they gonna be denied? Even if they stopped drinking for many years?
Doctor here who has referred patients for transplant. No. You must be six months sober to be eligible for the transplant list. There’s so few livers to go around, they need to be sure the recipient isn’t going to just break the next one.
It’s rare to suddenly need a liver; they usually take months to fail and this gives the patient and doctor months of notice to try treating the failure first (including lifestyle changes and meds) before getting sick enough to go apply for a transplant.
I used to trust HCPs, but I know many of them now and have heard them shit-talk and judge their patients for mental health issues and drug use (among other things). I would NEVER, EVER tell a doctor or nurse about any form of drug or alcohol use now, or any kind of anger issues that could possibly be interpreted as aggressive. Especially not in a hospital where everything gets recorded in an electronic chart and may be used against you in the future. Fuck that.
I’m sorry you have such a low opinion, maybe you heard someone venting about their job after work?
You really think lying about your drug use is safe? It’s dangerous to give many types of anesthesia if you’re on drugs or alcohol. We don’t particularly care if you use or not, we don’t tell police or family, you just need to be honest so we can do our job correctly.
If I was going under anesthesia for a planned procedure, I would not drink or use drugs beforehand. If it was an unplanned emergency, I guess it would depend on the circumstances, but you are citing an extreme circumstance. If someone is actively high at the time they end up in the emergency department, well, that’s bad luck and it might be wise to disclose since the staff will figure it out pretty darn quick anyway. Same if you are a severe alcoholic or opiate addict. That’s not what I’m talking about, though. I’m talking about when doctors or nurses ask you about it as a lifestyle question.
You know as well as I do that the health care system classifies people in terms of their risk factors and then use that profile to make decisions about you. Once classified as a “drug user” in your chart, many doctors and nurses will treat you differently. They may or may not “care” from a moral perspective, and we know that they won’t tell family or police, but that won’t necessarily stop them from denying you necessary pain relief or deprioritizing you in triage. That’s the actual concern.
There is absolutely no reason to tell a doctor if you use cannabis or engage in moderate alcohol use or occasionally use cocaine, LSD, or psylocibin. If you are prescribed a medication that has an interaction with a recreational drug, the doctor can simply tell you that. They don’t need to know if you use that drug from time to time. Only you, the patient, need to know that so you can avoid the interaction. More extreme forms of drug use are a different story, of course.
Edit: Let me add one other overarching point. I think people are sick and tired of having doctors make decisions for them. I don’t need a nanny. I need information about risks and benefits in order to make an informed choice. Doctors rarely do that. Instead, they decide what should be prescribed, or not prescribed, regardless of the patient’s wishes. I know the reason is fear of liability, but here we are nonetheless.
Ah, you think you know better than doctors. Many people think this. Many have bad outcomes with nobody to blame but themselves.
I don’t care if you use cannabis, heck I can legally prescribe you some if you need it. Doctors are not law enforcement. I don’t bat an eye if you tell em you use cocaine, I’ll still give you morphine after surgery but I need to know you used cocaine so I can avoid beta blockers. You’re paranoid we’re judging you but you’re wrong. You’re not as rare as you think. We know you’re in pain regardless of your drug use and treat you anyway.
Only you, the patient, need to know that so you can avoid the interaction
Many idiots who died in hospital thought that too, which is why we make you sign consent forms so that your family can no longer sue us for your stupid mistake.
It’s like you have no idea how doctors work and have an outdated idea of them. Your loss.
You misunderstand me. I don’t think I know better than doctors. Far from it. What I want from a doctor is information and informed choice, not a gatekeeper who makes decisions for me. As a group, physicians have been slow to adopt the patient-centered informed choice mentality that, for example, nurse practitioners and midwives have more thoroughly adopted.
The fact that you’ve doubled down here on calling patients idiots for being somewhat distrustful of the typical arrogant physician attitude confirms what I’m saying.
Their boyfriend was willing to be a living donor for them. So you aren’t talking about a scarce resource here.
She literally quit when she was told she had a failing liver that could not recover. Just to be clear, there is absolutely no way in hell that she didn’t know she was on the way to killing her liver with her drinking because there are a plethora of signs long before you get to the point where alcohol has destroyed your liver beyond its own ability to repair itself. (Which is incredibly prodigious. The liver is the single most regenerative organ in the human body)
So forgive me if I’m skeptical that she really would have stopped being an alcoholic after she received a liver transplant.
IMO this was a tragedy of her own making and the money and effort in transplanting a liver would have been a complete waste. (Even one offered by her SO.) Especially when there is such a deficit of available organs and the surgeons who do the transplanting are needed for patients who aren’t likely to go back on the sauce 6 months later.
the pain of a cramping liver is excrutiating. if you deal with that kind of unrelenting never stopping pain und don’t stop drinking, you are addicted for sure.
In most places, if they’ve been clean for 6 - 12 months, they are no longer considered alcoholic in terms of transplantation. Similar to Canada
Notice that they never state she was an alcoholic. They also never atate she was a “high level” alcohol user. Just that she was an alcohol user.
You can make your own assumptions about her alcohol use, but in general these rules would also excluse a “normal” alcohol user with a congenital liver failure…
And for good reason, really. The supply of livers is too small to save everyone who needs them, so they give them to the people most likely to have a successful outcome. Basically every lived given to one person is sentencing another person to death. That’s just reality with supply being what it is.
Their boyfriend volunteered as a live donor. They weren’t asking to be put on the general register.
Which was determined to be unlikely to be successful given her condition, so she would have just died in the attempt.
Read the article again. It said early on her chances were actually quite good, something like 80%
That’s not true. Living donors can donate part of their liver.
It’s incredibly sad to hear someone die of a preventable cause this young, but I can also somewhat relate with the people who reviewed her application.
If a living donor wouldn’t have been sufficient, they’ve now created two patients where they previously had one, and without improving the primary patient’s condition. It makes sense that a donor organ from a deceased donor would be preferable.
That said, the current requirement for the patient to meet deceased donor standards for transplantation to be eligible to use a willing living donor make no sense. Both situations should have their own unique criteria, given that a living donor situation involves different risks for both the patient and the donor than a deceased donor situation would incur.
Ultimately this whole situation boils down to a scarcity situation though. If we want to solve this, it will require more people to register themselves as a donor and a review of the eligibility criteria as soon as more donors are available.
And how prevalent and socially acceptable Alcoholism has become.
It’s not just acceptable, it’s encouraged by the province to keep people from rage quitting their lives here.
