Those who specialize in treating alcoholics say there s another large issue raised by the new policy, the issue of stigmatizing illnesses. The medical director of Oregon s Springbrook Treatment Program, Dr. Greg Skipper, says a quarter of the adults who get liver transplants have alcoholic cirrhosis. He questions why they are grouped status two when their post-transplant survival rate is similar to other transplant recipients. This could well represent stigma against people with chronic illness, particularly people with alcoholism. There is a stigma in the public about alcoholism, and this may be a manifestation of that.
Skipper says basing access to care on survival rates is the start of the slippery slope.
We could be moving toward a time when we re going to exclude care for a lot of chronically ill people, saying that the payoff is not as great. And some experts say the rationing policy shouldn t even be necessary. They say UNOS makes the liver shortage worse by distributing livers in the local areas in which they re donated, rather than sending them to where the sickest patients are. A liver donated in Seattle, for example, usually is transplanted in Seattle, even if sicker patients are elsewhere. That doesn t seem fair to Dr. John Roberts, who has more than 700 patients on his waiting list at the University of California in San Francisco.