Lung transplantation is a potentially life-saving procedure for patients with irreversible lung failure. Five-year survival rates after lung transplantation are >50% for children and young adults. But there are not enough lungs to save everyone who could benefit. In 2005, the United Network for Organ Sharing developed a scoring system to prioritize patients for transplantation. That system considered transplant urgency as well as time on the waiting list and the likelihood that the patient would benefit from the transplant. At the time, there were so few pediatric lung transplants that the data that were used to develop the Lung Allocation Score were inadequate to analyze and prioritize children, so they were left out of the Lung Allocation Score system. In 2013, the family of a 10-year-old challenged this system, claiming that it was unjust to children. In the article, we asked experts in health policy, bioethics, and transplantation to discuss the issues in the Murnaghan case.
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July 2014
Ethics Rounds|
Ethics Rounds|
July 01 2014
Was Sarah Murnaghan Treated Justly?
Jennifer deSante, MD;
Jennifer deSante, MD
aChildren’s Hospital of Philadelphia, Philadelphia, Pennsylvania;
eChildren's Mercy Hospital, Kansas City, Missouri
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Arthur Caplan, PhD;
Arthur Caplan, PhD
bDivision of Medical Ethics, NYU Langone Medical Center, New York, New York;
eChildren's Mercy Hospital, Kansas City, Missouri
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Benjamin Hippen, MD;
Benjamin Hippen, MD
cCarolinas Medical Center, Charlotte, North Carolina;
eChildren's Mercy Hospital, Kansas City, Missouri
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Giulano Testa, MD;
Giulano Testa, MD
dLiving Donor Liver Transplantation, Baylor University Medical Center, Dallas, Texas; and
eChildren's Mercy Hospital, Kansas City, Missouri
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John D. Lantos, MD
eChildren's Mercy Hospital, Kansas City, Missouri
Address correspondence to John D. Lantos, MD, Children’s Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108. E-mail: jlantos@cmh.edu
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Address correspondence to John D. Lantos, MD, Children’s Mercy Hospital, 2401 Gillham Rd, Kansas City, MO 64108. E-mail: jlantos@cmh.edu
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2014) 134 (1): 155–162.
Article history
Accepted:
March 13 2014
Citation
Jennifer deSante, Arthur Caplan, Benjamin Hippen, Giulano Testa, John D. Lantos; Was Sarah Murnaghan Treated Justly?. Pediatrics July 2014; 134 (1): 155–162. 10.1542/peds.2013-4189
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We appreciate the clarification and additional information provided by Judge Baylson. We also certainly did not mean to imply that his ruling was in any way influenced by factors outside of the courtroom; merely that the publicity associated with the patient's situation played an important role in the case being brought forward to the court.
Conflict of Interest:
None declared
I was the judge in the Murnaghan case discussed in your Pediatrics journal (Volume 134, Number 1). So your readers will have an accurate description of my ruling, I am enclosing the Order I entered on June 5, 2013 and a Memorandum I filed two days later explaining the reasons for the Order.
I also disagree with the suggestion that this decision was "in response to media and political lobbying."
Sincerely,
Michael M. Baylson
Enclosures
Order:
http://www.paed.uscourts.gov/documents/opinions/13D0477P.pdf
Memorandum:
http://www.paed.uscourts.gov/documents/opinions/13d0484p.pdf
Conflict of Interest:
None declared