by Jim Nintzel
Slate's Sally Satel looks at Arizona's decision to cut off funding for organ transplants:
The Arizona decision is doubly wrong, technically and morally. To regard transplantation as "optional" is a grievous medical error. When suitable patients receive organs, they can live meaningful and longer lives as parents, spouses, neighbors, and workers. Morally, it is troubling enough to deny life-saving treatment by never guaranteeing it in the first place; it is even worse to pull the plug on people's hope—and, with it, their lives. At the very least, the state should have grandfathered in those already assured of coverage. Then, going forward, in refusing to transplant those who could not afford it, Arizona would be making more explicit the economic rationing that already exists.
Uneasy questions of apportioning arise in environments of scarcity. Who will stay in the crowded lifeboat and who will be thrown to the sharks? This age-old tension between utility to society (the maximum good for the maximum number) and fairness to the individual is a crucible for American medicine. David C. Cronin, director of the Liver Transplantation at Children's Hospital of Wisconsin, sees Arizona's effort as a "dress rehearsal" for future cutbacks in a healthcare system where the government is poised to expand its role as insurer. "For a state agency to deny and even revoke approval for an accepted standard of care is new territory," he says.
Read the whole thing here.