Another interesting question is regarding the ethics of transplants for patients from other countries, regardless of criminal status.

UNOS says that providing transplant care to foreigners is "humanitarian". I can understand that, but since organs are in short supply, and presumably no organs would go unused in the absence of listing foreigner for transplant, is it more "humanitarian" to give an organ to a foreigner than to an American?

I work at a huge transplant center that performs organ transplants on foreigners. I've noted that a lot of the foreign transplant recipients are wealthy Kuwaitis, not impoverished people from poorer countries. They do not pay anything extra to be treated, but they pay cash for the surgery, hospitalization, and related testing. It should be noted that in general, hospitals charge more to patients who pay directly than they do to insurance complanies; as such, this hospital probably makes a lot more money off of transplanting a cash-paying wealthy foreigner than an insured American.

The LA Times had a series of stories a few years ago about area hospitals bumping foreigners up the list for cash. In one of the stories, they did mention that UNOS has a limit on the amount of foreign transplants each center can provide, I think it was 5%. Having such a low limit seems fair, may provide for contingencies or emergencies or even high paying individuals who make the other 95% of the transplants possible.

The real issue seems to be the centers that flaunt the 5% rule and/or take money from anyone, American or no, to be bumped up the list.

Yes my first question when I read this article was why is an American University funded with our tax dollars giving transplants to foreigners?

grout4cake:

Yes my first question when I read this article was why is an American University funded with our tax dollars giving transplants to foreigners?

I don't think it is relevant that this occurred at a hospital associated with a state university. I doubt the hospital at UCLA receives any more government funding than private academic hospitals. Their revenues are likely to be from the same sources as any other hospitals; i.e., billing for patient care.

Here is the link to the UNOS policies regarding transplantation fo foreign nationals. If the 5% number is exceeded, they are subject to review by the UNOS International Relations Committee.

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But even if it is a small number, that doesn't change the philosphical problems related to the issue. If you were an American on the waiting list, you might not be too happy that foreign nationals were getting American organs ahead of you. Especially if they might not be getting the organ if it was not expected that they would pay more than you. And I am referring to the patient-pay vs. insured-pay discrepancy (paying to be bumped up the list is clearly unethical and illegal and I believe - or at least hope - that it is a rare occurrence).

I also worked at an academic medical center with a top transplant program and many transplants are performed on foreign nationals (Kuwaitis, Saudis, Brazilians, etc.). My thought has always been that such countries have the financial means to establish their own transplant centers and don't -- I have always thought that part of the reason for that is a lack of a desire to provide transplant for ordinary folks -- the wealthy and well-positioned can always get on a plane and come to us.