ORGAN ALLOCATION: New Rules Blocked By Judge’s Order

      A federal judge in Louisiana yesterday blocked new federal rules on organ allocations that were slated to take effect today. The Baton Rouge Advocate reports that U.S. District Judge Ralph Tyson put a temporary block on the regulations "until he can rule on state claims that the rules are unconstitutional and will endanger lives." Earlier this year, the U.S. Health and Human Services Department announced the new rules in an effort to make the nation's organ allocation system fairer. While the current allocation system works on a geographic basis, the new rules would direct organs to the sickest patients, no matter where they live. Tyson's ruling prevents any change in policy until Oct. 14, when he will hear arguments in a suit filed by the state of Louisiana, the Louisiana Organ Procurement Agency and six Louisiana medical centers. In the case, the plaintiffs contend that the HHS rules "unconstitutionally infringe on the sovereignty of the state, illegally shift decisions on organ allocations from the private sector to the health department and would result in fewer organs donated and fewer lives saved." Louisiana Attorney General Richard Ieyoub (D) said, "The rule is disruptive and destructive as far as successful transplants are concerned." U.S. Sen. Bob Livingston (R-LA) said he would try to postpone the new rules for another year by attaching an amendment to a pending HHS spending bill.

Level Playing Field
      In a statement on Tyson's temporary order, HHS Secretary Donna Shalala said: "As far as medically feasible, there should be a 'level playing field' in organ allocation, and the patients should have an equal chance to receive an organ based on their medical need, no matter where they live or in what transplant center they are listed. Today's action by the Louisiana District Court unnecessarily delays the realization of that goal" (Pack, 10/1). The United Network for Organ Sharing, which has been one of the most vocal opponents of the new rules, filed an amicus brief on the side of the Louisiana challenge. UNOS President Walter Graham said there were "important legal questions" regarding the new rules. "Airing those issues before a federal court is an appropriate course of action," he said (Hostettler, Richmond Times-Dispatch, 10/1).

Disappointment
      University of Pittsburgh Medical Center, one of the most vocal supporters of the new rules, said it was disappointed by the delay. Dr. John Fung, chief of UPMC transplant surgery, said, "Every day the new rule is delayed means that more patients will be disadvantaged by the current organ distribution system and that more patients will die unnecessarily." A hearing on the injunction was canceled earlier this week because of Hurricane Georges, UPMC spokesperson Lisa Rossi noted. However, in a statement, UPMC "expressed confidence that when the court has a chance to weigh arguments on both sides, it will allow the rule to go into effect" (AP/Pittsburgh Post-Gazette, 10/1).

Survey Says ... Stay
      "Most people in Ohio would prefer that organs donated by state residents go to Ohio transplant patients, but more also support sending organs out of state if a patient there has spent more time on a waiting list or has a better chance of survival," according to a survey conducted by the Ohio Solid Organ Transplantation Consortium. In the survey of 846 Ohio residents, 78% said they "prefer that locally donated organs go first to local patients" when "all conditions are equal." But 79% said the person waiting the longest should receive the organ, "no matter where they live." In addition, 55% said they thought organs should first "go to the person with the best chance of survival," while 38% said they should first go to the sickest patients (Bonfield, Cincinnati Enquirer, 10/1).

Don't Know Much About Geography...
      In Monday's Roll Call, Sen. Rick Santorum (R-PA) and Rep. Bob Livingston (R-LA) take on the organ allocation debate. Santorum: "The new HHS guidelines would better meet procedural and substantive standards of justice than does current policy. They would encourage more public participation in the policymaking process and, therefore, more accountability and they would equalize the treatment of medically similar cases. In developing policies for the life-and-death issue of organ allocation, we should rise to broadly accepted standards of justice rather than acquiesce to narrowly defined regional interests" (9/28). Livingston: "It's no secret that people prefer to have transplant surgery close to home and that a higher percentage of people will agree to become organ donors if they know that it will benefit a neighbor or a relative in their home state. ... We don't need to fix a system that isn't broken. We need to stop Washington from grabbing more power over serious medical decisions. Big Brother has no business getting involved in organ transplantation" (9/28).