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[milestogo]

This message was self-deleted by its author (milestogo) on Sun Dec 19, 2021, 02:59 AM. When the original post in a discussion thread is self-deleted, the entire discussion thread is automatically locked so new replies cannot be posted.

[Maru Kitteh]

1. There's just no way

I could possibly agree with you any more than I already do.

[LastLiberal in PalmSprings]

44. In CA, a prisoner demanded his "right" to a new heart.

He was next on the transplant list. He even took to matter to court to force the state to do the procedure.

After the transplant was successful he refused to do any of the necessary aftercare (take meds, stop smoking) to ensure the new heart had the best chance of viability

Within a year he was dead. Understandably there was a hue and cry from people waiting for a heart, as well a the families of donors. Not only did he "waste" a valuable donation, the taxpayers had to foot the bill.

I understand why doctors, nurses, and hospital administers are tired of the "vaccine hesitant" COVID patients who end up in their ICU.

Stephen Colbert put it this way: "There are two types of people -- those who are vaccinated and Republicans."

[LastLiberal in PalmSprings]

45. In CA, a prisoner demanded his "right" to a new heart.

He was next on the transplant list. He even took to matter to court to force the state to do the procedure.

After the transplant was successful he refused to do any of the necessary aftercare (take meds, stop smoking) to ensure the new heart had the best chance of viability

Within a year he was dead. Understandably there was a hue and cry from people waiting for a heart, as well a the families of donors. Not only did he "waste" a valuable donation, the taxpayers had to foot the bill.

I understand why doctors, nurses, and hospital administers are tired of the "vaccine hesitant" COVID patients who end up in their ICU.

Stephen Colbert put it this way: "There are two types of people -- those who are vaccinated and Republicans."

[blueinredohio]

2. I second this idea.

[rsdsharp]

3. Mickey Mantle got a liver transplant. I don't necessarily disagree with you,

but the analogy would appear to be incorrect.

[BlackSkimmer]

6. So did Larry Hagman. nt

[Mister Ed]

21. And David Crosby. n/t

[BlackSkimmer]

27. Wow, I didn't know that about him.

Or if I did, I forgot. Interesting. Did his liver fail because of alcoholism?

[ms liberty]

38. Alcohol and drugs. n/t

[BlackSkimmer]

49. I researched it after I saw this thread.

Apparently he had Hep C.

What was really interesting is that Phil Collins paid for his transplant!

[ms liberty]

51. You're right, I'd forgot the hep c. I didn't know about Phi, wow. n/t

[Mister Ed]

47. I always presumed that he needed the transplant because of his severe chemical dependency, but...

...his Wikipedia article says that the immediate cause of his liver failure was hepatitis C:

Crosby was the recipient of a highly publicized liver transplant in 1994, which was paid for by Phil Collins.[55] News of his transplant created some controversy because of his celebrity status and his past problems with drug and alcohol addiction.[56][57][58] Crosby's liver problems stemmed from a long run with hepatitis C.[59]

https://en.wikipedia.org/wiki/David_Crosby

[milestogo]

50. Yeah I had a friend who had a liver transplant because of hepatitis C.

He was scheduled for transplant and rushed to the hospital 5 times. The first 4 times there was a problem with the liver, or the timing. He finally got a liver about 3 months after he was moved to the top of the list. But waiting and being called up repeatedly only to be disappointed was a harrowing experience for him.

[BlackSkimmer]

53. Ha, I posted before I saw your post!

[Demovictory9]

10. rich alcoholics get them

[rsdsharp]

16. If they come up as the number 1 match for the available donor organ.

I wouldn’t call Mantle rich. He had a long string of failed businesses, and profligate spending.

[SergeStorms]

40. And Mantle kept drinking....

after his transplant. I have first-hand knowledge of that fact. Mickey was one player who should not have been unleashed in New York City.

[rsdsharp]

52. You personally knew Mickey Mantle? Do tell.

Mantle’s transplant occurred on June 8, 1995. The cancer aggressively spread and he died August 13, 1995. So how much did he drink in that two month period — much of it spent hospitalized.

He also went through Betty Ford in 1994, and by all accounts (except yours, of course) he remained sober, even after the death of his son.

[SergeStorms]

56. Drinking in his restaurant...

with Bobby Mercer. And I really don't care if you believe it or not. I was there with them, but I didn't see you at the table.

[leftstreet]

4. Rich alcoholics can probably get anything they need n/t

[BlackSkimmer]

5. How about smokers?

Should they be refused care for heart problems caused by their use of tobacco? How about those who are morbidly obese and suffer health problems from that? Should an OD victim take a hospital bed from a person who needs it?

This is a very, very slippery slope.

[empedocles]

8. Triage?

[milestogo]

11. We're talking about allocating scarce resources, not refusing care in order to be punitive.

I am not aware that care for heart problems or obesity or addiction are scarce resources.

[BlackSkimmer]

12. Ventilators are quite often used in heart operations.

My father was on one during and after a valve replacement surgery.

How about a drunk critically injured in a DUI crash who needs a ventilator?

[milestogo]

15. Until its a scarce resource there's no need to choose.

But when hospital intensive care beds are at capacity, as they are now in some places... those choices are being made.

[BlackSkimmer]

20. I live a pretty healthy life.

I’ve never smoked, I’ve been a runner almost all my life, lifelong walker and swimmer, not obese.

But I really hesitate to see that kind of thing become standard. Jmho.

[milestogo]

22. This isn't happening in a vacuum.

It's clear that our health care system and our country was totally unprepared for this pandemic. Almost 2 years into it, we are still in a position where we do not have enough resources to take care of a surplus of very sick people.

Medical staff are burned out and leaving hospital work. New variants of this virus keep appearing. We have behaved as though this would be over in a year or so, but it's not over yet.

I never expected this level of vaccine resistance in this country. If people were cooperating with vaccination, there would not be an ICU bed crisis. But they are fighting vaccination, many for political reasons. It's costing money, and its going to cost lives. People are dying. Resources are not infinite.

[BlackSkimmer]

26. I don't disagree with you on that.

This has become a hugely preventable nightmare.

[Rhiannon12866]

32. I've often thought of that recently. My mother was in ICU and on a ventilator back in 2011

When she fell down the stairs during the power blackout caused by Hurricane Irene and she broke her neck.

[Skittles]

7. I see alcoholism as a disease, not a choice

just saying

[milestogo]

13. No matter which one it is, they don't get liver transplants

because its likely they will keep drinking and it will not be a long term success.

[Ms. Toad]

33. Yes, they do get liver transplants.

My daughter will require a transplant one day (due to an autoimmune disorder), so I a intimately familiar with the criteria for liver transplants.

Six months of sobriety is the maximum required, and some places require less. None in the US, to my knowledge, bar transplants beyond the 6-month sobriety requirement.

[Mariana]

14. Uncontrolled alcoholism greatly reduces the chance

that a liver transplant would be successful. I believe people whose livers have been destroyed by alcoholism are eligible for liver transplants if they stop drinking for a period of time.

[Skittles]

23. yes, six months

https://www.hopkinsmedicine.org/news/articles/destigmatizing-liver-transplant-for-patients-with-alcohol-use-disorder

[in2herbs]

36. I know a doctor who doesn't think that alcoholism is a disease because the person can

make the choice not to drink any more, not so with a disease. You can't wake up and decide you no longer have the disease.

[Skittles]

39. my brother drank himself to death at age 45

he was jaundiced, got a nosebleed and bled to death......he had tried many times to stop drinking.....so he apparently HE couldn't "wake up and decide" not to be an alcoholic

[CTyankee]

48. My sister in law died of alcoholism and was also a kind, sweet, funny woman who I loved very much.

Her father had been a beast. His reason was that her birth caused the death of his wife.

I don't know what would have saved her. I gave a short "remembrance" at her funeral and couldn't finish it because I was overwhelmed by crying. I thought I would never get over her death and wrote a daily journal about remembrances of her for the duration of this period of grieving.

Nowadays, I don't drink alcohol because it made me very sick. I really wish I could have saved her.

[captain queeg]

9. It is a slippery slope. But there ought to be some way to factor in poor choices or lifestyle.

[Mariana]

17. Alcoholics do get liver transplants.

They have to stop drinking for a period of time first, and they probably have to demonstrate that there's a good chance they'll remain sober after the transplant.

[FBaggins]

18. Untrue... and when it is true, it isn't as punishment for bad choices

Alcoholics can indeed receive liver transplants after a few months of sobriety.

But those who can’t aren’t being punished for bad decisions. It isn’t “you should have made better life choices so we aren’t going to waste scarce resources on you “

Triage isn’t “who deserves our care” - it’s “who needs it the most and is most likely to benefit “

[milestogo]

19. Some transplant centers will do them and others won't.

Triage for transplants also includes an age cutoff.

But I wasn't suggesting punishment. There are simply situations where choices have to made. Compliance with medical recommendations is not a bad criteria for rationing medical care.

[Spider Jerusalem]

24. Depends on the alcoholic; see for instance Mickey Mantle and George Best (n/t)

[Dorian Gray]

25. My husband and I went out to eat tonight

in Windsor Terrace in BK. We ate outside, and there was another couple a few tables from us. (Only two around.) They obviously knew the staff and were regulars bc they were talking with their waiter and having an argument about this very thing. They claimed they were both vaccinated but they believed it was your own choice. Waiter vehemently argued that as our hospitals are filling up, they unvaccinated should be not treated if hospitals were full. They were angry about that idea.

I am uncomfortable saying uniformly that they should not be treated, but prioritizing people who have the best chance of survival when hospitals are beyond full.... it's going to happen.

I am praying it doesn't happen here, but our local hospital (Methodist) is at 85% capacity with 25 covid patients and 5 available ICU beds. Woodhull is at 96%. Interfaith is at 89%. But luckily Brooklyn Hospital Center is only 50% and Maimonides at 69%. We have capacity here, but I'm worried about in two weeks.

(NY Times has a page that lists all our hospitals and how full they are and how many ICU beds are available. It's helpful if making a decision to go.)

[live love laugh]

28. They should be called the Great Haters. They Hate Greatness because they lack it. nt

[Cherokee100]

29. Separate

Separate hospitals for vaccinated and non-vaccinated people. Same with schools. Lets see how the anti-vaxers like that.

[Ford_Prefect]

30. Care Teams and specialist support used for such patients diminishes and depletes care available

and abuses staff and Doctors alike.

Intensive care beds and ventilators are not unlimited resources. If someone refuses recommended medical care, (and the Covid vaccine is recommended for everyone who can tolerate it) then they have no right to expect priority for a scarce resource.

[Ms. Toad]

31. Your title/premise is just plain wrong.

Alcoholics are eligible for liver transplants, as long as they have been sober for 6 months - AND - some transplant centers do not even impose a six month requirement.

Further, the 6-month requirement has nothing to do with second chances. It has to do with whether you can be expected to take care of the new liver (not what you did with your original model).

[GB_RN]

34. Triaging COVID Patients Has Already Been Done In Some Places

Idaho was doing it back in September, and Washington State was refusing to take patients from Idaho as WA was already full.

As the ICUs fill up (again), hospitals and states will have to make choices about who is most likely to live, and therefore, who to give care to. It's the same thing that's done in battlefield surgery...we just never expected it to be done in the domestic hospital scene because we've never been in this level of crisis mode before. I'm a nurse, and I lived through the first wave back in March to September of 2020. We thought it was bad then, and it was, but we had NO idea. The thought of getting to the point of triaging never crossed our minds at that point. Welcome to the hell that tRump and the GOPQ have wrought.

As long as antivaxxers/antimaskers and COVID deniers keep up their nonsense, and if the COVID variants that pop up continue to be extremely communicable and even partially lethal as Delta, then we're going to keep seeing waves that hit the hospitals - hard.

[radius777]

35. Agree, I would make antivaxxers sign an informed consent form

stating that (a) the medical community has found that the vaccines are safe and effective (b) that I nevertheless choose to refuse the vaccine (c) and I thus relinquish all medical care should I contract Covid.

These people are the reason we can't get the pandemic under control. A pandemic is a wartime situation where the collective good must supercede individual rights. What would FDR do? Yeah, you know.

[hardluck]

43. So we are reopening Manzanar?

I mean we’re in a wartime situation and all.

[AncientAndy]

37. Alcoholism also causes heart problems.

Should they be denied treatment for any heart conditions?

[Liberty Belle]

41. That's different.

There's no shortage of doctors availlable to do heart procedures, but there are never enough organs for everyone who needs one.

They won't give you a liver transplant if you have liver cancer or hepatitis, or at most centers if you are an alcoholic though possibly if you've quit drinking for a substantial period of time it might be different.

The anti-vaxxers are taking up ICU beds and ventilators needed by others; they should be a lower priority for an ICU bed than anyone with COVID who was vaccinated, and also those who need an ICU bed for a non-COVID reason such as a car accident or stroke.

[AncientAndy]

42. Ok so what if it's two vaccinated people and only one hospital bed?

Should their lifestyle choices be compared to figure out who is more worthy of living?

[Bucky]

46. NIH says "it's unethical to refuse treatment to patients for diseases that are preventable"

via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6876525/

Abstract

Most candidates for liver transplantation have irreversible cirrhosis caused by years of heavy alcohol consumption. Arguments against liver transplantation for alcoholics include the presumption of relapse to heavy drinking, which might damage the new liver or lead to its rejection. Corresponding ethical arguments focus on the presumption that alcoholics brought their condition upon themselves and should not compete with nonalcoholics for scarce donor livers. However, experimental data demonstrate that carefully selected alcoholics can survive liver transplantation and return to the workplace as productive citizens. Moreover, it has never been considered ethical for clinicians to refuse treatment to patients for diseases that are partly or wholly preventable.

[BannonsLiver]

54. Mickey Mantle got one.

[PTWB]

55. Miles, this is a fantastic post and a fantastic point.

If ICU beds are full and one of them is occupied by someone who refused the vaccination, pull them out of the ICU and give their bed to someone who is vaccinated. If the anti-vax loon dies, they die, and that's too bad, but they made the decision to refuse the vaccine.

While it is true that anti-vaxxers are dying at a rage of 10 to 1 over the vaccinated, those ICU beds are not exclusively used for COVID patients. I'd rather a vaccinated heart disease patient get that ICU bed over an unvaccinated COVID patient.

We just can't coddle these people. Their bad decisions and lack of personal responsibility are directly responsible for their deaths.

[Brainfodder]

57. Republicans got their DEATH PANELS after all?