title: Alcoholics and liver transplantation. The Ethics and Social Impact Committee of the Transplant and Health Policy Center.
abstract: Two arguments underlie a widespread unwillingness to consider patients with alcoholic cirrhosis of the liver as candidates for transplantation. First, alcoholics are morally blameworthy, their condition the result of their own misconduct; such blameworthiness disqualifies alcoholics in unavoidable competition for organs with others who are equally sick but blameless. Second, because of their habits, alcoholics will not exhibit satisfactory rates of survival after transplantation; good stewardship of a scarce lifesaving resource therefore requires that alcoholics not be considered for liver transplantation. These arguments are carefully analyzed and shown to be defective. There is not good moral or medical reason for categorically precluding alcoholics as candidates for liver transplantation. It would, in addition, be unjust to implement such a preclusion simply because others might respond negatively if we do not.
authors.affiliation: Transplant and Health Policy Center, Ann Arbor, MI 48109-0716.
authors.forename: C
authors.initials: C
authors.lastname: Cohen
authors.forename: M
authors.initials: M
authors.lastname: Benjamin
mesh_terms: D000437:Alcoholism; D001294:Attitude to Health; D004992:Ethics, Medical; D015438:Health Behavior; D015276:Health Care Rationing; D006291:Health Policy; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery; D016031:Liver Transplantation / Q000592:standards*; D009014:Morals; D018579:Patient Selection; D040841:Resource Allocation; D009927:Tissue and Organ Procurement / Q000600:supply & distribution; D014481:United States