From: Carrol Cox <cbcox-AT-rs6000.cmp.ilstu.edu>
Subject: M-TH: Liver transplants
Date: Fri, 27 Feb 1998 17:56:00 -0600 (CST)


I see Leo reads the daily newspaper more carefully than I do, hence his
concern with liver transplants. It seems according to a story in the
morning paper I just picked up there are 4000 livers each year for 7000
patients. At least in quantity the problem would be more difficult under
socialism (Note: I've never said a word about communism or the classless
stateless society), more difficult because clearly the gross inadequacy of
medical care in the United States today must cover up more than the 7000
patients, but then again perhaps there would be more donations in a
socialist society. It doesn't make much difference.

The debate now is a current system, the liver goes to the nearest patient,
vs. a proposed system in which the liver goes to those of most need. The
latter system, it seems, is favored by two groups: (a) the *large*
transplant centers, who are gypped out of their fair share of livers and
(b) those who like Leo lust for hard choices and demand that some moral
principle be invoked. Of course it is a political decision, not a moral
one, and turning it into a heavy handed system of "fairness" will exercise
the same sort of corrupting influence on the public intellect that the
death penalty does. One simply must not invoke the whole formal dignity of
the state around issues life and death.

So probably the current hit or miss system of who is closest is least
politically damaging. I can't see it as a question very many will take to
the barricades over in either a capitalist or a socialist state. My
first wife was on a waiting list for a kidney in the summer of 1968 but
died of a shunt infection before her name came up. I don't think either of
us even under those conditions (and I wasn't a Marxist yet then) really
thought that there should be any very elaborate system of selection. We
just hoped for the best.

So I come back to my original response to Leo: it makes my blood run cold
to imagine someone making a big moral deal out of selecting patients for
organ transplants. It's best kept as casual, and at as low a level in the
bureaucracy, as possible. Anything else would be corrupting of the public
mind.

Carrol



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