Cost of stigma...Eligibility for liver transplantation may be lowered by psychiatric diagnoses

Hmmm, but it's those damned word nazis that are the real problem.
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http://www.news-medical.net/news/20130404/Patientse28099-eligibility-for-liver-transplantation-may-be-lowered-by-incarceration-marijuana-use-and-psychiatric-diagnoses.aspx

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Currently, the model for end-stage liver disease (MELD) is used to measure the severity of liver disease. The MELD score provides transplant providers with standardized criteria to allocate donated livers. However, the authors point out that subjective assessment of the candidates’ medical and psychosocial characteristics could influence the providers’ selection process.

To further understand the ethics involved in selecting transplant candidates, Dr. Levitsky and colleagues sent an online survey to hepatologists, surgeons, psychiatrists and social workers at 102 liver transplant centers across the U.S. Responses were received from 251 providers who answered questions regarding their opinions of characteristics that could prevent patients from receiving a liver transplant.

The majority of responders were male (71%), between 41 and 60 years of age (68%) and mainly white (77%). The three characteristics ranked most controversial were incarceration, marijuana use, and psychiatric diagnoses. Responses from transplant providers indicate that 63% would not waitlist patients 80 years or older, 57% would not transplant patients with a body mass index (BMI) greater than 45 kg/m2, and 55% specified incarceration with lifetime sentence a contraindication to liver transplantation.

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