February 21, 2003

  • I feel deeply for Jessica Santillan who has undergone a second heart-lung transplant to correct surgeon James Jaggers’ original wrong blood-type transplant mistake (using type-A organs while Jessica had type-O blood).  But now she has 'complications' which shouldn’t have been unexpected since 'complications' are much more likely in re-transplants. 


    Was it fair for her to go immediately to the top of the transplant list because of the surgeon’s mistake?  Or should some rule of triage have deemed someone else waiting, with a similarly dire need but much better prospects for success, higher on the list than her?


    The issue of such re-transplants has sparked a debate through the years, specifically regarding the fairness of giving organs to a patient for a second time, when other sick people are waiting for their first transplant. Arthur Caplan, who has written extensively on organ transplants and is director of the Center for Bioethics at the University of Pennsylvania, says re-transplants pose ethical questions.


    "When you're trying to rescue someone from death's door and you're doing a repeat transplant, it is well-known that the outcomes are worse [than first transplants]," Caplan said yesterday.


    "From a public policy point of view she should not be at the top of a list for a transplant after the first one failed," he said.


      -Newsday


    And even if she lives and is eventually fine, which I surely hope is the outcome, should the surgeon James Jaggers not be held accountable of wasting organs that would have surely been someone else’s last best chance before sure death?


     I suspect that Duke University Hospital’s inclination is not to hold him accountable, if she survives , since it has already given him a  'second professional chance' in performing Jessica’s transplant a second time.  I sense they want to treat this incident like a dice roll of ‘double or nothing’: "if she lives, you’re the hero-surgeon; but if she dies, it’s your career".

    I feel tragically, in a twilight sense, however, for the very next person who is on the waiting list for those particularly-typed organs (type-A ; there are 199, in all, for all types) that were wasted, and who dies because no organs become timely available.  And I feel that the survivors of that yet unnamed but doomed patient should be allowed to hold this surgeon, James Jaggers, and Duke University Hospital accountable for a grievously bungled, lost chance for their loved one at life.

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