Comments on: The Seattle ‘God Committee’: A Cautionary Tale http://healthaffairs.org/blog/2009/11/30/the-seattle-god-committee-a-cautionary-tale/?utm_source=rss&utm_medium=rss&utm_campaign=the-seattle-god-committee-a-cautionary-tale The Policy Journal of the Health Sphere Thu, 24 May 2012 07:58:29 +0000 hourly 1 By: The only easy decision about organ donation is registering as a donor Read more: http://www.philly.com/philly/blogs/public_health/138579894.html#ixzz1lPF4G5YW Watch sports videos you won't find anywhere else http://healthaffairs.org/blog/2009/11/30/the-seattle-god-committee-a-cautionary-tale/comment-page-1/#comment-160669 The only easy decision about organ donation is registering as a donor Read more: http://www.philly.com/philly/blogs/public_health/138579894.html#ixzz1lPF4G5YW Watch sports videos you won't find anywhere else Sat, 04 Feb 2012 10:08:26 +0000 http://healthaffairs.org/blog/?p=2998#comment-160669 [...] decisions about who gets an organ based on “society’s values.” This method, also known as “The God Committee,” was (in)famously used at Seattle’s Swedish Hospital in the 1960s to make dialysis rationing [...] [...] decisions about who gets an organ based on “society’s values.” This method, also known as “The God Committee,” was (in)famously used at Seattle’s Swedish Hospital in the 1960s to make dialysis rationing [...]

]]> By: dotCommonweal » Blog Archive » Ethics at the Edges of LIfe http://healthaffairs.org/blog/2009/11/30/the-seattle-god-committee-a-cautionary-tale/comment-page-1/#comment-151470 dotCommonweal » Blog Archive » Ethics at the Edges of LIfe Wed, 18 Jan 2012 19:21:35 +0000 http://healthaffairs.org/blog/?p=2998#comment-151470 [...] might find profitable to consider.  The issue first came up in the 1960’s with the “Seattle God Committee,” in which a committee decided who would have access to kidney dialysis. The committee considered not [...] [...] might find profitable to consider.  The issue first came up in the 1960’s with the “Seattle God Committee,” in which a committee decided who would have access to kidney dialysis. The committee considered not [...]

]]> By: vck.chn http://healthaffairs.org/blog/2009/11/30/the-seattle-god-committee-a-cautionary-tale/comment-page-1/#comment-31703 vck.chn Wed, 02 Dec 2009 20:58:53 +0000 http://healthaffairs.org/blog/?p=2998#comment-31703 Unfortunately, this gut decision has now put the government in a terrible situation. It pays for dialysis, an expensive therapy which has been shown to decrease both one's quality of life and life expectancy significantly after even the first time. A kidney transplant prior to dialysis is the best intervention to prolong years of life and preserve quality of life. For Medicaid patients, tranplantation is free and so is 3 years of immunosuppresant drugs, which are necessary to prevent rejection. While working under a kidney transplant surgeon, I have seen many poor patients stop taking their drugs after the 3 years because going back to dialysis is free and the drugs were not even close to cheap. So, their bodies reject the kidney, which is removed, and they return to dialysis. This, in fact, has created a lose-lose situation and one with a great deal of waste and inefficiency. How does this seem like a situation we want to emulate again today? Certainly we should make decisions objectively and transparently without considering social wealth. However, this is not equivalent to a univeral access version of give everything to everyone; rather there should be decisions made, as they do in the UK with their NICE committee, about what interventions are most cost-effective and for what groups. These decisions should not be made based on social wealth, but instead, using evidence-based care. For example, you mention the H1N1 allocation-- certain groups have been shown to be more susceptible to H1N1 such as pregnant woman. Therefore, it makes sense they should get priority, but not because they are carrying the next generation. Unfortunately, this gut decision has now put the government in a terrible situation. It pays for dialysis, an expensive therapy which has been shown to decrease both one’s quality of life and life expectancy significantly after even the first time. A kidney transplant prior to dialysis is the best intervention to prolong years of life and preserve quality of life. For Medicaid patients, tranplantation is free and so is 3 years of immunosuppresant drugs, which are necessary to prevent rejection. While working under a kidney transplant surgeon, I have seen many poor patients stop taking their drugs after the 3 years because going back to dialysis is free and the drugs were not even close to cheap. So, their bodies reject the kidney, which is removed, and they return to dialysis. This, in fact, has created a lose-lose situation and one with a great deal of waste and inefficiency. How does this seem like a situation we want to emulate again today?

Certainly we should make decisions objectively and transparently without considering social wealth. However, this is not equivalent to a univeral access version of give everything to everyone; rather there should be decisions made, as they do in the UK with their NICE committee, about what interventions are most cost-effective and for what groups. These decisions should not be made based on social wealth, but instead, using evidence-based care. For example, you mention the H1N1 allocation– certain groups have been shown to be more susceptible to H1N1 such as pregnant woman. Therefore, it makes sense they should get priority, but not because they are carrying the next generation.

]]> By: uberVU - social comments http://healthaffairs.org/blog/2009/11/30/the-seattle-god-committee-a-cautionary-tale/comment-page-1/#comment-31687 uberVU - social comments Wed, 02 Dec 2009 01:31:02 +0000 http://healthaffairs.org/blog/?p=2998#comment-31687 <strong>Social comments and analytics for this post...</strong> This post was mentioned on Twitter by healthy: Health Affairs Blog: As uncomfortable as it is for many Americans to accept, allocation issues are a permanent feat... http://bit.ly/4RdwHj... Social comments and analytics for this post…

This post was mentioned on Twitter by healthy: Health Affairs Blog: As uncomfortable as it is for many Americans to accept, allocation issues are a permanent feat… http://bit.ly/4RdwHj…

]]> By: dcohen9 http://healthaffairs.org/blog/2009/11/30/the-seattle-god-committee-a-cautionary-tale/comment-page-1/#comment-31679 dcohen9 Tue, 01 Dec 2009 17:33:12 +0000 http://healthaffairs.org/blog/?p=2998#comment-31679 Thank you, Carol. This is a discussion that we very much need to have in this country. Thank you, Carol. This is a discussion that we very much need to have in this country.

]]> By: RobertBurney http://healthaffairs.org/blog/2009/11/30/the-seattle-god-committee-a-cautionary-tale/comment-page-1/#comment-31675 RobertBurney Tue, 01 Dec 2009 03:33:53 +0000 http://healthaffairs.org/blog/?p=2998#comment-31675 But Grandma is not safe. "Effectiveness Research" committees will determine what care she can or cannot have, and age or cost will probably be criteria. The Brits have been doing this for years with their NICE committee. See article, "My Drug Problem" in the Mar 09 issue of The Atlantic. Dialysis is an excellent example of what's wrong with our system today. "If you pay for it, they will come." Gawande described the pernicious nature of this principle in his New Yorker article about McAllen, TX. But Grandma is not safe. “Effectiveness Research” committees will determine what care she can or cannot have, and age or cost will probably be criteria. The Brits have been doing this for years with their NICE committee. See article, “My Drug Problem” in the Mar 09 issue of The Atlantic.

Dialysis is an excellent example of what’s wrong with our system today. “If you pay for it, they will come.” Gawande described the pernicious nature of this principle in his New Yorker article about McAllen, TX.

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