title: Was Sarah Murnaghan treated justly?
abstract: Lung transplantation is a potentially life-saving procedure for patients with irreversible lung failure. Five-year survival rates after lung transplantation are >50% for children and young adults. But there are not enough lungs to save everyone who could benefit. In 2005, the United Network for Organ Sharing developed a scoring system to prioritize patients for transplantation. That system considered transplant urgency as well as time on the waiting list and the likelihood that the patient would benefit from the transplant. At the time, there were so few pediatric lung transplants that the data that were used to develop the Lung Allocation Score were inadequate to analyze and prioritize children, so they were left out of the Lung Allocation Score system. In 2013, the family of a 10-year-old challenged this system, claiming that it was unjust to children. In the article, we asked experts in health policy, bioethics, and transplantation to discuss the issues in the Murnaghan case.
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;
authors.forename: Jennifer
authors.initials: J
authors.lastname: deSante
authors.affiliation: Division of Medical Ethics, NYU Langone Medical Center, New York, New York;
authors.forename: Arthur
authors.initials: A
authors.lastname: Caplan
authors.affiliation: Carolinas Medical Center, Charlotte, North Carolina;
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hippen
authors.affiliation: Living Donor Liver Transplantation, Baylor University Medical Center, Dallas, Texas; and.
authors.forename: Giulano
authors.initials: G
authors.lastname: Testa
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;Division of Medical Ethics, NYU Langone Medical Center, New York, New York;Carolinas Medical Center, Charlotte, North Carolina;Living Donor Liver Transplantation, Baylor University Medical Center, Dallas, Texas; andChildren's Mercy Hospital, Kansas City, Missouri jlantos@cmh.edu.
authors.forename: John D
authors.initials: JD
authors.lastname: Lantos
mesh_terms: D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000941:ethics* / Q000331:legislation & jurisprudence; D009927:Tissue and Organ Procurement / Q000941:ethics* / Q000331:legislation & jurisprudence; D014481:United States
keywords: child; cystic fibrosis; ethics; justice; lung transplantation; resource allocation