To think that someone’s past shouldn’t be taken into account when offering them medical treatment?

[AlternativePerspective]

www.bbc.com/news/world-us-canada-60010155
So it’s emerged that the man who received the pig heart transplant served a 10 year sentence for stabbing someone in 1988. The victim’s family have now been all over the news saying that he shouldn’t have received the treatment, and they are upset that they weren’t consulted about it first.

While I totally understand that they will be upset, it should go without saying that no-one’s treatment should depend on their past, and that surgeons should never be expected to make judgements on moral grounds.

But also, I’m not sure these people should be given a platform to express their outrage.

The treatment this man received is pioneering, and if successful could pave the way to further such treatments in the future. This shouldn’t IMO be overridden by an insistence that it should never have been allowed to happen on the basis that he is who he is.

Medical and lifestyle issues obviously have an impact on what treatments are suitable and appropriate. Moral judgements are a completely different issue.

Care dhould be allocated ny need not merit.

I agree his past should have no baring on his medical treatment, but it should maybe have been taking into account of the publicity around it. There really was no need to have his pictures published all over the place.

It’s a shame for the victim’s family that his picture has been splashed all over the press, bringing back bad memories.

As for the surgery, I do wonder it the doctors were a bit “Aha! Finally someone to test out the pig’s heart theory.”

Ethically medically you're correct

That said I personally think he shouldn't be out of prison anyway and if he were still in prison he wouldn't have got the heart would he?

Although @Highwind has a point too

Some past behaviour impacts medical decisions and that's as it should be - alcoholics and transplants being one example where it can have a negative impact, sometimes it can have a positive one.

Some rules are pretty outdated now yet continue - eg not allowing gay men to donate blood in the same way as the rest of the population - only very recently slightly improved

You can't sentence someone all over again, which is what would have happened here if he'd been denied treatment. It would have been a death sentence.

@Graphista those are medical judgements, based on the likely efficacy of the treatment/longevity of the recipient/quality of the donated product, however outdated and misguided the judgement may be.

Making a pure value judgement on the basis of somebody's past criminal behaviour is completely different.

Unsure why the victim's family feel they should have been told about this. It is not like they have a right to veto any medical treatment this man needs. It has absolutely nothing to do with them whatsoever.
His criminal past (and he would get treatment even if incarcerated anyway) has no bearing on any medical needs he has.

An alcoholic not being offered a transplant is not a moral judgement on them being an alcoholic, its a judgement based on the chance of success of the transplant and the availability of transplants.

People who smoke are still offered lung cancer surgery, even if they are advised heavily to stop.

We don't make a moral judgement on someone's character to decide whether they get medical treatment or not. And we most certainly cannot ask the victims family to make a decision as to what treatment is appropriate for this man

Completely agree.

Also, this is besides the point but does anyone else remember a pig heart transplant being a storyline on Ally McBeal in the 90s? The man who received the pig heart was suing the surgeon because he hadn't given consent to have pig's heart, even though it saved his life.
The pig was called Michael. John Cage (was that his name? The short lawyer who used to say "Poughkeepsie") went "The pig had a name. Say it with me. Michael." to the jury.

Why do I remember this in such detail?

@AwaitingSueGraysInvestigation

I agree. Moral judgements about medicines and medical procedures are dangerous and a slippery slope in my opinion. This is why the whole mandated vaccines for covid sits so uneasily with me personally.

This man served his sentence, presumably. That doesn't bring back the person he killed but according to the rules laid down by the society he and his victim live/d in, he paid his debt to that society.

The victim's family have no right to have any view whatsoever on this person's medical needs and treatment. The fact that they have suffered is entirely unrelated to the needs of him as a patient. Neither cancels the other out -- so what he did was still wrong, but his medical requirements are also what they are, and the two have nothing to do with each other.

Of course they are allowed to have a view on this. Whether that view affects his actual medical management is another thing

But yes they are allowed a view on what should happen to someone who murdered their loved on.

*Of course they are allowed to have a view on this. Whether that view affects his actual medical management is another thing

But yes they are allowed a view on what should happen to someone who murdered their loved on*

It has made headline news, and anyone can have a view on whatever is in the news.
However, this family wanted the right to be told about the man's surgery prior to the news and him having it. They do not have the right to that information.

I agree his past should have no baring on his medical treatment, but it should maybe have been taking into account of the publicity around it. There really was no need to have his pictures published all over the place. this surgery was groundbreaking. It’s inevitable that it would be in the news.

And it will likely continue to be in the news if he A, dies, B, lives a long time, or c, (which is a definite possibility,) if the pig heart enables his health to improve to the extent he will then become eligible for a human donor heart.

At the time didn't the man basically say "if this works I get to live and if it doesn't you've got more medical knowledge"?

I think that's pretty admirable. He was willing to sacrifice his life for medicine. I'd say, considering how many lives this treatment will now go on to save, that he's paid his dues.

I'm sure my opinion would be different if I knew the victim though.

Also, we have no idea what kind of person he is now compared to 34 years ago, none what so ever.

To the PP who said he should still have been in prison, he didn’t murder the bloke, the bloke did apparently die 20 years later of potentially associated complications, but by then this man had already served his 10 year sentence for battery.

To the PP who said he should still have been in prison, he didn’t murder the bloke

Well no, but judging by the 7 stab wounds and his victim being left paralysed, it wasn't for want of trying.

The point the family has been making was they are still living with the consequences of the attack.
One sibling committed suicide because of this
The one who got stabbed needed life long support but (being the US) had no support so his parents had to take loans etc etc just so that their house could be adapted for him (by that I mean ramps, not s9methng excessive)
Etc

On the other side, they see a man who spent a few years in prison and then got to live his life to the fullest. Has a family, children and grand children etc…

So it feels extremely unfair in that they are still paying a high price, even now whereas he doesn’t (and even got ‘extra’ support)

Now it is possible that he is actually crippled by remorse and guilt who knows. But that’s not how it looks from afar iyswim.

think that's pretty admirable. He was willing to sacrifice his life for medicine

His life was already on the line though. He needed a heart transplant and It was a last resort. There really wasn't another option for him.

What I have much more issue with is the fact he never showed much interest in his own life. He was refused as a patient in the first place by a few hospitals because he didn’t turn up to follow appointments, didnt take his medication regularly etc… so of course his condition deteriorated a lot.

So yes in paper, I agree that someone past should not define what sort if care they receive.
On the other side, there are many many other patients who are/were in the same position than him and could have been eligible. People who actually take their medication regularly (totally essential if you have a transplant) for example.

think that's pretty admirable. He was willing to sacrifice his life for medicine

Nope. He isn’t scarifying anything seeing that he was told he would die soon. That there was nothing they could do. So he had NOTHING to save there. He took no risk because the situation just couldn’t get worse than what it was for him anyway.

However, this is giving him a glimmer of hope. A second chance that no one else has had before. That’s something to be extremely grateful about rather than seeing him as a hero that ‘took some many risks’.

[ quote="Pofre"]Of course they are allowed to have a view on this. Whether that view affects his actual medical management is another thing

But yes they are allowed a view on what should happen to someone who murdered their loved on.[/ QUOTE]

Of course anyone is entitled to have a view on anything, but I find it odd that the BBC have given this view a platform, as if it has any consequence here. I think that is pretty irresponsible of the BBC and a poor editorial decision. The stabbing victim's family are not entitled to any consultation on this nor are they entitled to a public "right of reply" either.

As a doctor, one does not (and should not) make moral judgments as to whether patients “deserve” treatment.
I have treated many convicted criminals as patients over my 36 years in the NHS, including an axe murderer and several wife beaters.
The only patient I refused to treat was the arsonist who set my own house on fire, risking my children’s lives. I ensured that a colleague was available to take him instead - and I only refused because I could not trust myself to behave with the professional courtesy required.

I completely agree with you. The sheer beauty of Nye Bevan’s policy for universal healthcare was that everybody, irrespective of their past, religion, status or wealth, would receive healthcare as much as the next person. This man was entitled, in every way, to the same healthcare as the nicest person in the country. If we don’t observe this then what we have is a social credit system and that’s very, very dangerous. Unless you actually WANT to live in a dictatorship

I don't even understand this one. It's so clear. It's about a medical emergency! It's private, important information, and -access to healthcare- is a very basic human right. I mean... why should they be consulted?

I am pretty sure this man has since died anyway.