Should addicted alcoholics be refused liver transplant?
Alcohol liver disease – Some Facts:Excess and prolonged alcohol consumption affects the liver, nervous system, cardiovascular system, gastrointestinal system, muscles and the reproductive system. These people are also at higher risk of cancer of the mouth, pharynx, food pipe, and liver associated with prolonged alcohol abuse.
Legal definition for drunk driving in India: blood level of 100 mg/dl
Blood level of 200 mg/dl can lead to inebriation
Blood level of 300-400 mg/dl can lead to coma, respiratory arrest and death.
Diseases caused by excessive drinking:- Fatty change (hepatic steatosis): can be treated by stopping alcohol and following a well balanced diet.
- Acute alcoholic hepatitis: treatment is same as fatty change but usually leads to cirrhosis.
- Cirrhosis: liver transplant is the only treatment
Rules for liver transplant of alcoholic in India need him to follow the below mentioned guidelines:- No alcohol for at least 6 months
- Regular blood testing
- Involvement in ongoing unofficial alcohol behaviour programs
- Acceptable psychosocial maintenance based on the benchmark set by the psychiatry experts and social services
Yes, refuse! 1. Long queue:There are any patients awaiting liver transplant in India and the number of liver available are far less than needed. There aren’t many donors and the illegal organ trade has been developing rapidly because alcoholics are too many and they are accepted for liver transplant. Sober people should be given the go while alcoholics should be denied straightforward.
2. Self induced problem:Consuming excess alcohol is not a natural problem or something that man has no control over. They choose to ignore the warning. The health risk with excess alcohol consumption is not a hidden fact. Everyone is aware of it. They choose to ignore and are later worried about their liver. This is unacceptable.
3. A social evil:People who are deliberately addicted to alcohol, especially the underprivileged ones create a lot of trouble to get alcohol. Most of them sell their land and property to quench their addiction. They spend their hard earned money in alcohol, leading to distress in family. Some drink and drive, and cause accidents. Others lose their clam when drunk and break law and order. They should definitely be denied a transplant.
4. They will go back to drinking:In most of the cases it has been seen that the alcohol addicted people would refrain from alcohol until the transplant and with a fresh new liver, they would begin all over again. It is a waste of treatment, a healthy liver that could have been given to someone else who would take care of it. People who are rich are ignorant and believe that money can buy them a brand new liver.
No, they have a right to live too! 1. Right to live:Being an alcoholic isn’t a crime. Most of them are depressed people. Drinking became an addiction for them before they could understand the outcome. This doesn’t prove that they have no right to live if they could. A liver transplant, which can save a life, should be their right and should not be denied if carried out with a legally approved donor.
2. Undetermined:According to doctors, it is very difficult to determine if liver problem arose out of alcohol consumption or any other abnormality. Unless there is alcohol in blood at the time of diagnosis, it is very difficult to know if the person was a sworn alcoholic once. If denying to alcoholics becomes a rule, there will be no solid evidence to prove the cause of liver disease.
3. Recovering alcoholic:Once an addict, always an addict doesn’t really apply in the case of alcohol. The patient could actually be trying to quit or has already quit. He might be determined to lead a healthy and alcohol free life after the transplant. Such rules in some countries are very harsh on such people who lose hope in life very soon.
4. Death sentence for alcohol?Denying them a transplant is like giving death sentence for drinking. This would be unjust and unconstitutional. Doctors are meant to save lives wherever they can. If there is the slightest chance that the person, who might have a family to support, can live then he should definitely be given the chance.
It is agreeable that denying a transplant is unfair and countries that practice it need to amend their laws. Delaying treatment is also unjust. It should be determined that they refrain from alcohol and given rehabilitation later if required.
