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Opening Arguments

Life and death, by the rules

Now we're getting into scary territory:

Health and Human Services Secretary Kathleen Sebelius rebuffed an appeal from Rep. Lou Barletta on behalf of a girl who needs a lung transplant but can’t get one because of a federal regulation that prevents her from qualifying for a transplant.

“Please, suspend the rules until we look at this policy,” Barletta, a Pennsylvania Republican, asked Sebelius during a House hearing Tuesday on behalf of Sarah Murnaghan, a 10-year-old girl who needs a lung transplant. She can’t qualify for an adult lung transplant until the age of 12, according to federal regulations, but Sebelius has the authority to waive that rule on her behalf. The pediatric lungs for which she currently qualifies aren’t available.

“I would suggest, sir, that, again, this is an incredibly agonizing situation where someone lives and someone dies,” Sebelius replied. “The medical evidence and the transplant doctors who are making the rule — and have had the rule in place since 2005 making a delineation between pediatric and adult lungs, because lungs are different that other organs — that it’s based on the survivability [chances].”

"Someone lives and someone dies" is, of course, the brutal reality. There are too few available organs and too many people in need of transplants, and someone has to use some system to decide who gets one and who does not. It's just chillingly creepy to hear that so casually laid out by a government bureaucrat instead of a medical professional. The concern is over who makes the decision and what the guidelines are. If it's some government drone, whatever the rules are will be blindly followed, no matter what the factors in a specific case might be to warrant a suspension of the rules.

Why in the world should there be an arbtrary age trigger for who's eligible for an adult transplant, instead of medical criteria to determine if an individual child could handle the transplant or not? Arbitrary age limits are important in some aspects of the law -- who can get a drivers' license, for example, and who can legally drink. It would be an administrative nightmare to figure out which 14-year-olds are able to drive and which 17-year-olds can't handle it. But "arbitrary" and "life and death" are not a good mix.