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Allocation of transplantable organs: do people want to punish patients for causing their illness?

Publication ,  Journal Article
Ubel, PA; Jepson, C; Baron, J; Mohr, T; McMorrow, S; Asch, DA
Published in: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
July 2001

Some people believe patients with alcoholic cirrhosis should not receive equal priority for scarce transplantable organs. This may reflect a belief that these patients (1) are personally responsible for causing their own illnesses, (2) have poor transplant prognoses, or (3) are unworthy because they have engaged in socially undesirable behavior. We explore the roles that social desirability and personal responsibility have in people's judgments about transplant allocation. We presented prospective jurors with 4 scenarios, asking them to distribute 100 transplantable organs among 2 groups of 100 patients each. In each scenario, 1 group of patients, but not the other, was described as having a history of unhealthy behavior (alcohol or cigarette use) associated with a poorer prognosis. In some scenarios, alcohol or cigarette use was said to cause the organ failure. In others, it only contributed to the patients' transplant prognosis. We also obtained self-reports of subjects' own smoking status. Subjects allocated significantly fewer than half the organs to those with unhealthy behaviors and worse prognoses (33%; P <.001), but the specific behavior (alcohol versus cigarette use) was not significantly associated with subjects' allocation choices. Significantly fewer organs were allocated to patients with behavior responsible for causing their diseases than to other patients (P <.0001). Subjects who never smoked discriminated the most and current smokers discriminated the least against patients with a history of unhealthy behavior (P <.0001). The public's transplantation allocation preferences are influenced by whether patients' behaviors are said to have caused their organ failure.

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Published In

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

DOI

EISSN

1527-6473

ISSN

1527-6465

Publication Date

July 2001

Volume

7

Issue

7

Start / End Page

600 / 607

Related Subject Headings

  • Tissue and Organ Procurement
  • Surgery
  • Social Desirability
  • Smoking
  • Risk-Taking
  • Punishment
  • Prognosis
  • Middle Aged
  • Male
  • Lung Transplantation
 

Citation

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Ubel, P. A., Jepson, C., Baron, J., Mohr, T., McMorrow, S., & Asch, D. A. (2001). Allocation of transplantable organs: do people want to punish patients for causing their illness? Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 7(7), 600–607. https://doi.org/10.1053/jlts.2001.25361
Ubel, P. A., C. Jepson, J. Baron, T. Mohr, S. McMorrow, and D. A. Asch. “Allocation of transplantable organs: do people want to punish patients for causing their illness?Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 7, no. 7 (July 2001): 600–607. https://doi.org/10.1053/jlts.2001.25361.
Ubel PA, Jepson C, Baron J, Mohr T, McMorrow S, Asch DA. Allocation of transplantable organs: do people want to punish patients for causing their illness? Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2001 Jul;7(7):600–7.
Ubel, P. A., et al. “Allocation of transplantable organs: do people want to punish patients for causing their illness?Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 7, no. 7, July 2001, pp. 600–07. Epmc, doi:10.1053/jlts.2001.25361.
Ubel PA, Jepson C, Baron J, Mohr T, McMorrow S, Asch DA. Allocation of transplantable organs: do people want to punish patients for causing their illness? Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2001 Jul;7(7):600–607.
Journal cover image

Published In

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

DOI

EISSN

1527-6473

ISSN

1527-6465

Publication Date

July 2001

Volume

7

Issue

7

Start / End Page

600 / 607

Related Subject Headings

  • Tissue and Organ Procurement
  • Surgery
  • Social Desirability
  • Smoking
  • Risk-Taking
  • Punishment
  • Prognosis
  • Middle Aged
  • Male
  • Lung Transplantation