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Originally posted by: jphelan
So here we are 4 years after this thread and we have similar insurance policies nationwide and a shortage of organs to transplant. So who decides who gets a kidney? I assume it is the medical community on the basis of need - in essence a "death panel" as it has always been. I am still more comfortable with the medical community making this decision than the government. We are still in desperate need for Tort reform and allowing insurance companies to sell insurance across state lines.
Originally posted by: jphelan
So here we are 4 years after this thread and we have similar insurance policies nationwide and a shortage of organs to transplant. So who decides who gets a kidney? I assume it is the medical community on the basis of need - in essence a "death panel" as it has always been. I am still more comfortable with the medical community making this decision than the government. We are still in desperate need for Tort reform and allowing insurance companies to sell insurance across state lines.
Geez, jphelan. It wasn't, and isn't "the government" who decides, and it IS medical specialists who determine risk versus benefit of kidney transplant for the individual patient. You can use the term "medical communities", because the 'community' of medical specialists (like the AMA, for one) do set standards for the practice of their field. So, good news. But there is no longer a panel or committee, rather individual pratitioners who see patients and evaluate their condition, make recommendations, refer them to a kidney specialist (not to a panel) when indicated.
OK, you personally could label it death panels in the 1950s-60s, but you would be wrong. Those panels or committees included medical experts making excruciating decisions for "life". The few dialysis machines or centers with a machine or two sprung up here and there were due to the dedication of individual physicians who knew about dialysis, that their otherwise healthy patients with kidney failure could have their lives extended if only this procedure, dialysis, was available.
It was bloody, it was painful, it was costly to manufacture machines, to buy machines, to train and pay staff to operate the machines. Did I mention that one dialysis session could take 8 hours back then, if everything went smoothly, and longer than that to sterilize and re-set the equipment for another patient? Actually, sometimes 24 or 48 hour treatments were done, to give somebody a week's worth of life until he could get another treatment. And this was nobody but the doctors and nurses, not mandated by anybody, no rules, just willing to work long and hard hours to help the patients and expand this area of knowledge and practice.
My nursing career put me smack in the middle of dialysis and transplantation (1974-2014), so I know of what I speak. Thankfully, the modern era of dialysis was beginning.
The history of dialysis is enormously interesting. Dialysis machines took up a whole room, kinda like computers did. The first treatments of record occurred in Holland during the Nazi occupation, under covert conditions (by the good guys, not the Nazis). Very primitive machinery, limited successes. Like other inventions that ultimately proved successful.
We are now in modern times. EVERY person with kidney failure is elgible for dialysis, even if they haven't got a penny. EVERY dialysis facility is REQUIRED to educate EVERY patient about kidney transplantation, and give the patient opportunity to opt in or out for an evaluation for a transplant. If the patient wants to be evaluated, it is REQUIRED that the center refer him to a transplant surgeon (in some cases a transplant nephrologist) for evaluation.
The transplant medical experts make decisions about the patient's medical condition and whether or not they recommend transplant, based on what they believe is in the patient's best interest, as in all decisions regarding medical intervention.
It is all very complex, if anyone wants to ask a question or challenge me.
But I need to go and do some house cleaning. But, please, ask me anything about it.
Can you tell I am passionate about this topic? Retired, but still passionate.
