Organ transplant decisions should be made by doctors, not courts

It’s wonderful that the 10-year old suburban Philadelphia girl in need of a lung transplant whose plight became national news was finally able to get one on Wednesday. “God is great! He moved the mountain!” exclaimed Sarah Murnaghan’s mother, Janet Ruddock Murnaghan, on her Facebook page.

Actually, it was her parents who took her case to court and a federal judge who moved the mountain. The judge ordered that Sarah, as well as an 11-year-old boy waiting for lungs at the same hospital, be allowed to compete for them on an equal basis with adults.

Transplantation always entails an extraordinary mix of heartache and joy. Someone must die and donate organs, so someone else gets a chance to survive. Meanwhile, people waiting for organs often die while people ahead of them on the list get organs and live.

Everyone on an organ waiting list is desperate and everyone deserves a chance. But how those chances are doled out is a complicated process, particularly with lung transplants. People waiting for lungs are grouped according to age—children under 12, adolescents, and adults—and get priority for lungs from donors in their age group. As Alan Zarembo reported in the Los Angeles Times, the rationale behind the rankings takes into account difference in lung size, different medical criteria, death rates, and survival rates.

We don’t let people buy organs and we don’t let someone’s race or religion dictate where they stand in line for them. Nor should we let the civil courts--or the court of public opinion--subvert medical decisions. As painful as it might have been, the judge should not have intervened. That doesn’t mean that people shouldn’t be thrilled that young Sarah did get an organ. We should be heartened when anyone has a successful transplant.

The methodology behind a transplant waiting list can change. (In fact, until 2005, the lung transplant list was simply first-come, first-served.) And national organ network officials are now studying whether the lung transplant list should be adjusted again. That’s fine. But who gets an organ and when must remain a decision made by medical experts.

The real way to fix this problem, of course, is to have more people designate themselves as organ donors. I confess that I am not a donor. But we should all consider it.

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