Sarah Murnaghan is a ten-year-old girl suffering from cystic fibrosis. If she does not get a lung transplant, she will die, likely within weeks. But so far she has been unable to receive a lung transplant because a federal agency—the Department of Health and Human Services (HHS)—has decided that children under twelve must be placed on the bottom of the waiting list for an adult lung, and because a child lung is highly unlikely to become available.
Why is the federal government involved in a matter of organ transplantation? As an HSS Web page explains, Congress passed the National Organ Transplant Act in 1984, creating the Organ Procurement and Transplantation Network (OPTN), an organization subject to HHS oversight.
Many are asking whether the secretary of HHS, Kathleen Sebelius, has legal authority to make an exception to the HHS-approved rules. Sarah’s family says that Sebelius has “very clear authority under the law to intervene and mandate a variance that would help save Sarah's life.” Congressman Tom Price says that Sebelius possibly could save Sarah’s life by “signing a paper” permitting her to join the adult transplant list. Sebelius, however, declined to intervene on the grounds that changing the rules for one person would be unfair to others on the transplant list. She has called on OPTN to review the transplant rules related to children, but any change would come too late for Sarah. It is not even clear that Sebelius could intervene in Sarah’s case if she wanted to, as Brett Norman writes for Politico.
Although the extent of Sebelius’s authority remains unclear, what is clear is that the HHS, through its transplant rules, effectively operates as a death panel, deciding who may live and who will die—and that the federal government is in the business of rationing organs.
Not only does the federal government ration organs; it also actively reduces the supply of available organs by prohibiting “financial incentives for selling an organ.” Because the government forbids people to arrange for the sale of their organs upon their death—which would selfishly benefit their heirs—relatively few people offer their organs for transplant. Consequently, fewer people who need organs get them, and more people die—by government mandate.
The spectacle of a federal bureaucracy deciding who will and who will not receive organs is obscene. The government has no moral right to dictate any such thing. The moral right to make such decisions lies with private individuals, hospitals, and donation networks interacting voluntarily. The only proper role of government in this regard is to protect people’s rights and to enforce legitimate contracts.
In the present case, we can probably do little more than hope that Sarah, the brave little girl who declares, “I’m never going to quit, never, never,” will receive the transplant that may save her life. But for future Sarahs or Johnnys or the like—who could be our own children or someone we love—we can fight to extricate government from the transplant process so that more people have a fighting chance to live.
- Health Care and the Separation of Charity and State
- Altruism: The Morality of Suffering and Death (Exhibit 347R: Organ Donation)
- Time for the Ethics of Organ Donation to Catch Up with the Heroics of Dr. Joseph E. Murray
Image: Wikimedia Commons