Conceptions of reciprocity: The Navarro transplant case, organ allocation and undocumented immigrants – Emily Avera

Access Denied | Emily Avera

Organ donors give the gift of life, but the sheer volume of patients hoping for transplants far outstrips donor generosity. How should we make decisions to ensure the equitable distribution of a limited supply of organs? In a system that depends on the goodwill of donors and public trust, this question becomes further complicated when undocumented immigrants seek transplants – especially in the United States, where undocumented immigrants consent to donate organs more often than they receive them. In light of this fact, should citizenship be a substantial consideration? Or should allocation decisions be made according to a claim of reciprocity – i.e., that individuals or groups who are willing to donate are more entitled to receive organs than others?

In the recent case of Jesus Navarro, assertions of reciprocity became a key factor in driving public awareness. Navarro, a 35-year-old father from Oakland, California, became the focus of media attention when it was reported that he might not receive a needed kidney transplant because of his immigration status. This prompted a public campaign on Navarro’s behalf led by Donald Kagan, who himself received a transplant from an immigrant donor. The campaign thereby accentuated a key dilemma: how can an allocation system justify a policy of readily accepting organs irrespective of immigration status, but deny transplants based on the same criterion?

In responding to these public advocacy efforts, Chief Medical Officer Dr. Josh Adler at the University of California San Francisco (UCSF), the hospital handling Navarro’s case, issued a joint press release with Navarro that differentiated between Navarro’s comprehension of the situation and the hospital’s official policy:

[Navarro's] undocumented immigration status … was a concern for UCSF because it increases the risk that Mr. Navarro will not … receive the follow-up care and medication needed to stay healthy after a transplant …

Mr. Navarro has told UCSF that, to him, this meant he would not get a transplant until he resolved his immigration status; this was not what UCSF was trying to convey. Instead, UCSF was following its policy to make sure Mr. Navarro would continue to have the health insurance necessary to receive proper post-transplant follow up.

Read more: http://accessdeniedblog.wordpress.com/2012/05/14/conceptions-of-reciprocity-the-navarro-transplant-case-organ-allocation-and-undocumented-immigrants-emily-avera/

{Register to be an organ,eye and tissue donor. To learn how, www.donatelife.net or www.organdonor.gov}