ORGAN ALLOCATION: Senate Committee Passes Compromise
In a step to resolve the bitter dispute over the nation's organ transplant allocation system, the Senate Health, Education, Labor and Pensions Committee yesterday voted unanimously to approve a measure that would give a panel of experts ultimate say over how organs are distributed, the AP/Philadelphia Inquirer reports. Sponsored by Committee Chair and former transplant surgeon Sen. Bill Frist (R-Tenn.), the legislation would allow the United Network for Organ Sharing (UNOS) to write allocation policy, but it would establish a 21-member panel of experts to resolve any disputes that may arise between UNOS and HHS. The panel would consist of seven members selected by HHS, seven by UNOS and seven by the independent Institute of Medicine (Meckler, 4/13). Frist said that the measure "will help to balance the difficult ethical and medical decisions that accompany decisions about how organs are distributed." HHS Secretary Donna Shalala said, if enacted, the compromise "would provide a sound foundation for moving toward a better, fairer" system. The legislation will be sent to the Senate floor for full consideration following next week's congressional spring break (Cimons, Los Angeles Times, 4/13).
Still Far Apart
Although Frist agreed to add a provision clarifying that the system should "work to reduce geographic disparities in the system," the legislation does not address the main source of conflict: whether organs should be allocated to patients who live close to the donor, as the current system allows, or whether the sickest patients should receive top priority. And, the Senate measure varies greatly from last week's House-passed measure that essentially strips HHS of its authority in the matter (AP/Philadelphia Inquirer, 4/13). UNOS spokesperson Mark Rosenker cautioned that while "[p]rogress is being made," a compromise between the House and Senate will not be a "cakewalk" (Hostetler, Richmond Times-Dispatch, 4/13). While Reps. Thomas Bliley (R-Va.) and Michael Bilirakis (R-Fla.), two main backers of the House measure, did not comment on the Senate action, a House staffer said, "We are still on opposite sides of the Grand Canyon on this" (Rosenbaum, New York Times, 4/13). Sen. Edward Kennedy (D-Mass.) added that reaching a compromise in the two bills would be like trying to "cross a Chihuahua with a Great Dane" (AP/Philadelphia Inquirer, 4/13).