Viewpoint: Is Gareth Anderson a suitable case for a liver transplant?
The family of Gareth Anderson, the 19-year-old man who desperately needs a liver transplant, intends to go to court to challenge the Health Service’s transplantation policy.
The rules say that a patient should be alcohol-free for six months before they can be considered for the operation. But Gareth may not live that long, so acute is his condition. His family want the rules ignored in this very special case and there is not a family in the land who would think otherwise if it was their son in such a terrible plight.
This is an occasion when rules or guidelines drawn up for very good reasons seem at odds with humanity. Gareth’s acute liver damage may well be the result of over-indulgence in alcohol. He appears to have led a lifestyle which involved heavy or binge drinking on occasion. This is borne out by comments and pictures on his social networking sites. Yet his behaviour is no different from that of thousands of other young men or women and occasional heavy drinking is often regarded as nothing more than a rite of passage for his age group.
What is unusual is for someone so young to be so badly affected. Therein lies the medical profession’s dilemma.
Livers, like all donor organs, are in very short supply. Demand always outstrips supply and the reasons for liver damage can involve disease as well as alcohol abuse. It is quite proper that doctors want to carry out transplantation operations on those patients who will benefit most and who have demonstrated that their lifestyle will give them the optimum chance of making full use of their second chance.
In the case of those patients suffering liver damage through alcohol abuse, it is not unreasonable to ask them to show that they can control their drinking. We all recall the tragic case of George Best, who was given that precious second chance, but still continued to drink because of his alcoholism.
Drinkers are not alone in being asked to show a change in lifestyle before being offered medical treatment for a wide range of conditions. Doctors will also refuse operations to people who are overweight or who smoke, for example, when that impairs the chances of a successful procedure.
Gareth’s case highlights two problems – the lack of donor organs and the culture of heavy drinking, particularly among the young. Periodically, politicians consider an “opt out” system where people are deemed to agree to donation unless they make it clear that they don’t want their organs used. That would increase the number of donors, but some people feel it is an intrusion into civil liberties.
Preventing binge drinking is a more difficult problem, involving more education, stricter licensing laws and curbing the availability of cheap drink. As far as Gareth and his family are concerned the arguments on how to get more donor organs or how to change drinking habits are academic at this stage. Their desire is simply to get a life saving operation for Gareth. Given his age and the acute nature of his illness, it would be tragic if rules prevented him getting a second chance at life.