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Published: Monday, 6/24/2013


Science and sympathy

It is natural to rejoice in the news that a 10-year-old girl in Pennsylvania has gotten a desperately needed lung transplant, after rules that cover organ procurement and allocation were bent to address her medical need.

Sarah Murnaghan faces a complicated recovery with widespread public support for the accommodation that was made to save her. There is potential for even greater good to result from her case — but not if such decisions can too easily be taken away from medical professionals and handed off to judges.

Sarah and another young cystic fibrosis patient benefited from the Murnaghan family’s intense media and legal fight, calling attention to the so-called under-12 rule of the Organ Procurement and Transplantation Network. The organization, which oversees the national organ distribution system, required that any lungs from adult donors must be offered to adult patients on waiting lists before any patient under 12 could be considered. It didn’t matter if the children were far sicker than the adults.

A federal judge ordered Sarah and the other child onto the adult list because of their urgent need. The network, which rightly should be making those calls, initially criticized the judge’s decision.

But the organization then took the long view. It eased the rules applied to children for a year while the issue is studied carefully. This was an important change.

Ordinarily, the transplant rules should be uniformly followed, and not subject to a judge’s ruling or a family’s ability to wage a public campaign. Yet given the ever-improving practice of transplanting organs, periodic re-evaluation of what works best for patients is vital.

Such a review should reassure patients that the rules are in sync with the latest medical technology. If potential recipients are excluded from transplants based on outdated regulations, patients and the public could lose faith that the system is fair. That could hurt organ donation.

Although polls suggest that Americans support organ donation in theory, far fewer people with driver’s licenses are actually registered to donate. Campaigns in Ohio and across the country aim to increase the number of registered organ donors. That would be the best possible outcome.

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