Thomas Roberts   |  June 07, 2013

Second child placed on adult transplant list

Debate over the age restriction for lung transplants intensifies, as a second child is temporarily placed on the waiting list for adult lung recipients. David Magnus, director of the Center for Biomedical Ethics at Stanford University, and Howard M. Nathan of the Gift of Life Donor program discuss.

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This content comes from Closed Captioning that was broadcast along with this program.

>> the controversy over the age restriction of transplants is in the news today. javier is the second child who has been ? placed on the adult list for organs. a judge temporarily made an exception for sarah moynihan to be placed on the list. so now there is a ruling for children under 12 years of age to be placed on the same list as adults. joining us is a bioethicist from stanford university , and also, howard from the gift of life organization. howard , why are children not under the age of 12 allowed to get adult lungs?

>> well, the concept was that kids need kids' organs and typically the organ has to fit inside of the child, and that is the most important part, and not only how sick they are, but how the organ fits into the child. and i think that the concept was that to put them on the adult list was be superfluous, and there are some cases where the organs have been cut down, but they are very, very rare operations.

>> david , if we look at the statistics right now out of roughly 1,700 people waiting for a lung transplant , 16 of them are children under the age of 11, so is the judge doing the right thing to make these exceptions or setting up the potential that the judicial system is going to be seen as playing favorites here, and the same issue that ? secretary kathle kathleen sebelius had raised?

>> this is a disaster and it is really, really important that the people who donate organs believe in the system and fair system which does a good job of marshaling and stewarding this incredibly scarce source. in situations like this, we are talk about the young patients and the possibility of getting adult organs put into them, it is a difficult issue as are all of the allocation issues and ethcysts and surgeons and experts on the different organs find a lot of time to find the exact policies and they change them and revisit them over time , but that is the right way to do it, experts and not congress and not a judge.

>> howard , from your organization's standpoint that we need to revisit, because right now, because of this controversy and especially in regard to the government's role in insuring life saving access to health care , do you believe that the cases show an area, because there needs to be something shown up that we are missing out on something, and that we need to revisit why these kids are falling through the cracks ?

>> well, the biggest issue, thomas, is the shortage of organs and what we need to do is to get the public to see that this happens everyday. there are 118,000 people waiting and 6,500 in the philadelphia region alone. and if we had more organ donors and more organs available, many of the issues would not occur. ? certainly what david says is absolutely right, the optn has been thoughtful about this. and the models that have been developed have been done by experts in the field, and it is a very transparent policy, and certainly, if there needs to be a review, i'm all ears and i think that the rest of the community is, but i think that the real issue is organ donation , and organ donors in our, and for people to register.

>> i want to make sure though that we hear, because lawmakers are weighing in on the issue and i want everybody to hear from pennsylvania senator pat toomey who had this to say on the senate floor yesterday. listen.

>> i am not asking secretary sebelius to make an exception for one individual, but asking for a change in a policy that is flawed and currently excluding somebody from being on the list for, to be an organ donor recipient that ought to be on the list.

>> david , he is asking for overall here, and where should they draw the line here on this and other medical issues, and you believe they are opening up a can of worms here?

>> yes shgs s, it is the wrong way to develop policy. we have a situation of a lot of media and concern for a single individual, and now congress is weighing in, and the way to develop allocation policies is to have the experts work through it. they have done it very successfully and they have changed recently the way in which the kidneys are ale located, but it is a complex process that allows people with expertise to really looking at what produces the best results to do a good job ? of marshalling this very, very scarce resource.

>> gentlemen, thank you so much for joining us. david magnus and howard nathan and it is important for us to continue talking about this, because there are a lot of parents out there who would like people in washington, d.c. to make some decisions that would be helpful for their kids. thank you, gentlemen. we