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Subscribe to RSSDick Cheney has just joined a list of high-profile people, including Steve Jobs, Mickey Mantle, Evil Knievel and David Crosby who, received a transplant and thereby created a controversy. Cheney received a heart on Saturday from an anonymous donor at Inova Fairfax Hospital in Virginia after a 20-month wait. What is controversial about that? Cheney is 71 years old.
He has been through numerous previous operations that indicate he has other serious medical problems. He has only been able to survive due to the implantation of a left-ventricular assist device (LVAD) — a partial artificial heart -- that has kept him going long past the point where his own heart could have kept him alive.
For some patients, it's a bridge until a transplant may be possible. Others, who do not qualify for a transplant, live out the rest of their lives with an LVAD. So despite his age and health problems, how was Cheney able to get a heart while many others wait?
It is concerning that a 71-year-old got a transplant. Many of those who manage to even make the waiting list for hearts die without getting one. More than 3,100 Americans are currently on the national waiting list for a heart transplant. Just over 2,300 heart transplants were performed last year, according to the United Network for Organ Sharing. And 330 people died while waiting.
According to UNOS, 332 people over age 65 received a heart transplant last year. The majority of transplants occur in 50- to 64-year-olds.
Most transplant teams, knowing that hearts are in huge demand, set an informal eligibility limit of 70.
Cheney is not the first person over 70 to get a heart transplant. He is, however, in a small group of people who have gotten one. Why did he?
Cheney has an advantage over others. It is not fame or his political prominence. It is money and top health insurance.
Heart transplants produce bills in the hundreds of thousands of dollars. The drugs needed to keep these transplants working cost tens of thousands of dollars every year. Organ donations are sought from the rich and poor alike. But, if you do not have health insurance you are far less likely to be able to get evaluated for a heart transplant much less actually get a transplant.
The timing of Cheney’s transplant is ethically ironic given that the battle over extending health insurance to all Americans reaches the Supreme Court this week.
If the President’s health reform bill is deemed unconstitutional, those who are wealthy or who can easily raise money will continue to have greater access to heart, liver and other forms of transplantation than the uninsured and underinsured.
It is possible that Cheney was the only person waiting for a heart who was a good match in terms of the donor’s size, blood type and other biological and geographical factors. If not, then some tough ethical questions need to be asked.
When all are asked to be organ donors, both rich and poor, shouldn’t each one of us have a fair shot at getting a heart? And in a system in which donor hearts are very scarce, shouldn’t the young, who are more likely to benefit both in terms of survival and years of life added, take precedence over the old?
Let’s hope we get some answers to these tough questions as we watch both Cheney’s recovery and the fate of health care legislation that is intended to minimize the advantages that the rich now have over the poor when it comes to proven life-saving treatments.
Msnbc.com news services contributed to this report.
NBC's chief medical editor Dr. Nancy Snyderman explains why former vice president Dick Cheney received a heart transplant at age 71 when there are many younger people on the donor list and discusses what complications he may face.
Correction: An earlier version of this report incorrectly characterized how patients typically fare after getting a left-ventricular assist device (LVAD). Studies show that many patients improve and experience better quality of life on an LVAD. The device is approved to be used in two ways, as a Bridge-To-Transplant for those who qualify for a transplant and as Destination Therapy for those who do not.
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My dad was told when he was 65 that he was to old to get on a heart transplant list, but when he was in his 70's he suffered a heart attack and they did all they could to save him and he lived to the old age of 99 then passed of old age,
Wow! That's inspiring. Thanks Diana.
Politics and his behavior aside (ethically I think we all agree that he should not receive a transplant, right?) but even following the usual rules to simply be on an organ donation list, he does not qualify. He is too old and has been too sick for too long which means that after years and years of heavy duty medications which cause damage to your system and other organs, he would no longer be a VIABLE candidate and therefore invalidate his being able to even be considered as a recipient.
While young people remain on the list, some of them will die while awaiting the needed organs, plus the fact that only people with a certain type of insurance will be considered due to the costs.... means that most of the population and people like me and my family who have been uninsured for a long time... would be sentenced to death. This is neither democracy or decency.... and should NOT be allowed to happen.
Very interesting that you assume that everyone agrees that "he should not receive a transplant" I think you need to check your facts as to the fact that Cheney's age does not preclude him from having a heart transplant. Also, he waited with his name on the transplant list, just like all the others.
Very sad that liberals, which I am, are leaving vile, and vicious messages regarding Dick Cheney or anyone's life and death. I feel ashamed as I'm reading and I've come to see how mean and cruel people can be just because a person see's life and politics differently.
I think the whole main ingredient of being a "liberal" is that everyone should be free to speak their mind, practice whatever religion they want to and espouse any political view they choose. But I'm not seeing that attitude practiced here lately and it's sad.
Seriously, does anyone think that a government run health care is going to be "fair"? You will still have people picking and choosing winners. Do you really think it will be a neutral non-bias group who are not influenced by funds, donations or political pull that will make a purely cost benefit decision on who gets a heart? We know this because politics have never been influenced by money. I am not saying that the way things are is good, but lets not be delusional that health care will some how now become "fair". The more difficult the procedure the more it cost, hospitals and research labs need money to provide such life saving techniques. There is a business side to health care. If that wasn't that case then all health care would be free, doctors would do it purely for the benefit of saving lives.
"Fairness" is liberal progressives' Utopian dream. (It's impossible and had "unfair" unintended consequences.
Another problem is most patients that use health insurance mistakenly think that their health insurance premiums entitle them to unlimited, unfettered health care, i.e. keep one alive, no matter the cost.
Dr. Caplan, did you raise these ethical questions when Steve Jobs moved to Kentucky in order to get a liver transplant, even though it is highly likely that his prognosis for surviving even with a transplant was very remote? When you say that every one should have an equal chance at getting an organ transplant, does that include people who smoke, drink, do drugs, or are clinically obese?
I don't engage in any of those risky behaviors, and I exercise strenuously every day. I also eat in moderation, with a balanced low-fat diet. Should people who have carelessly abused their bodies and allowed their health to suffer as a consequence, have an equal chance for an organ transplant with those who have worked hard to preserve their health?
Maybe it's just people with money who should be denied access, or better yet, just Republicans with money who should be deemed ineligible? In addition to your credentials as a physician, as a part-time minister of social-justice, what say you?
"Dr. Caplan, did you raise these ethical questions when Steve Jobs moved to Kentucky in order to get a liver transplant, even though it is highly likely that his prognosis for surviving even with a transplant was very remote?"
Actually, he did in this 2009 article - Did Steve Jobs’ wallet help cut transplant wait?
To bad this was wasted on a mean OLD man. Any person of average income and his age would have been turned down so fast. Money does talk and it just said I screwed you again. Lets get true health care for ALL
Very sad that you have this view of a human being because they don't share your politics. Every life is valuable including those who don't agree with you.
I'm not sure what actual "proof" you have that Dick Cheney is mean. You're the only one who has displayed what "mean" really is.
Look everybody! Art Caplan is vying for a position on the US Single Payor Death Panel! Why are there no bioethicists demonstrating what's unethical about prohibiting individuals from making money off their organ donations; or what's unethical about forcing individuals, doctors, and nurses to opt-in to a highly-regulated, expensive healthcare bureaucracy? It certainly couldn't be because there are no government grants for such
commentaryresearch.You want ethics? How about the ethics of making a living spewing favorable government talking points while earning money that was taken by force from your fellow citizens?
I agree. I too am sad for those who tear down people, having no idea what the facts of the case is.
How many times do I have to go to MSNBC.com to get the news and not learn my lesson? I won't be back, believe me. I know now why the nasty anchors and commentators (Matthews, Maddow, & Co) have a home here...the people who post to this site and obviously listen to them are just as nasty. You can disagree with Dick Cheney...thank God we live in a country where you can and not end up in prison...but please people, keep it civil and stop the unbelievably horrible comments that are not worthy of us as Americans. The man has a family just like you, is a human being with failings JUST LIKE YOU. Look in the mirror and then judge. You strike me as the unhappy ones.
Al- You talk about nastiness then name Matthews and Maddow, who compared with ALL at faux noise, are the fair and balanced ones, at least their claims can hold up to factcheck! Wow, and I bet you support our President right? Kettle???
Hey al, I know you probably think of yourself as a good christian or something....but...this guy is a Dick...not just any Dick...he's a major Dick...he's probably one of the biggest Dicks that this country has known in a long time...and for a long time he was a Heartless Dick...No...I'm afraid he's nothing like most of us...he's a DICK...
The man killed nearly a million innocent people.. UNLIKE me
After reading more of the comments on this post, I just feel sad for all of you...
My only hope and wish will be that the new heart has an early expiration date - like one week. He has so much Iraq blood on his hands and he knows very well he is going to Hell, so why prolong it. He instigated and fueled the Iraq war and we have thousands upon thousands of our American boys recuperating from the loss of eyes and limbs, while this SOB gets a heart transplant! There really is no justice in this country! Shooting the SOB would be too good - torture him would be best.
Most everyone wants to live. Young and old. Although, Cheney certainly doesn't deserve a second chance.
Oh, okay. You are now deciding who deserves medical help? I didn't know you had that authority. Hmmm
I would like to believe that Mr. Dick Cheney the proverbial "Tin Man" received his new-found heart from a gay man who was an environmental activist, a peace activist and a dyed in the wool Democrat. Perhaps these implant traits might lead Mr. Cheney to pursue a more harmonious life. The cumulative acts of Mr. Cheney while Vice-President of the United States are criminal to say the least and should be looked into more broadly and deeply so he might hopefully someday be prosecuted for his acts against consciousness and against the American people now that his life has been renewed and untimely death delayed. If there really is a God, I have hope Mr. Cheney will soon receive the judicial review he so greatly deserves.
Well, our EX-Vise Criminal In Chief has managed to get a heart transplant. It took him only 20 months to get one. It's probably a good thing that we don't know how many 'mortal humans' were passed over so Cheney could get this transplant. I want that kind of health insurance but can't afford it under Obamacare.
The man shot a lawyer. That alone should earn him a new heart. :)
So the Prince of Darkness has a human heart for the first time in his life ... and another undeserved deferrment from the Grim Reaper.
I can't believe the comments I'm seeing on here. Put the politics aside and focus on the real issue of the heart transplant. I don't think that we should be judging who lives and who dies, people are entitled to live no matter what age they are
First off I hate Cheney with a passion. With that in mind everyone has to know and understand why the former leaders of our country (and we know he ruled for the first 4 years) should get special treatment. I would feel this way for Clinton, Gore, Bush I, Carter, Mondale. Beyond the power the rich can afford better health care. Guess what that is true everywhere and always will be. If you can drop a million to live an extra 10 years than good for you, but everyone can't do that, it just isn't economically feasible.
I see that the Bigots are out in force on this posting.
I don't think hating one guy, or even all vice-presidents, counts as bigotry.
Bioethic concerns? Is that lib speak for death panels?
Let me try to explain: in your current state, you would never be approved for a heart transplant. Unless you pull 7 figures, you will be passed over. Under the new guidelines, it would seem to be easier for you to joky for position against older, sicker, wealthier people.
Even this is incomplete, as medicine advances, there may be no need to create priorities whatsoever. We won't have this problem forever.
Read the "bioethicists" opinion, "too old". No judgement if an ex Vice President can contribute more in the next 10 years than a 20 year-old on the list, no reward for being a Congressman, an advisor, a top government and corporate official. Do you really think next year when the panel's kick in, that your grandmother stands a chance of surviving if it takes an expensive procedure -- pure politics will decide, since the officials on the committee will be appointed by the President.
I almost hope you voters don't live to be "old" -- and as we get deeper in debt, the definition of "old" will get younger and younger.
Interestingly, this "bioethicist" didn't make the decision based on race, gender, national background, sexual preference -- and therefore is prejudiced against seniors, and a friend of the government. Next year this guy's opinion decides if you live or die, and if that doesn't scare you, you're not paying attention.
Your post..........I can't tell what you are arguing for.
Tom either you are an idiot, or a parrot.. which is it?
Transplants should be reserved for human beings. He doesn't qualify.
Is Cheney to old for a heart transplant ? The answer is No, he's to MEAN, not to old!
I'm really getting sick of the Stupidity going on in this country of labeling people.What is old?Does anyone really know? The answer is a RESOUNDING NO YOU DON'T!
Stop Labeling People just because of their age! That's called DISCRIMINATION You Pathetic Idiots!
uhhh, yeah we DO know what old is,, there are life expectancies for people, given their state of health and previous conditions. DICK is well beyond his and is not a candidate for a successful transplant. It is too bad he got one
Oh give me a break!No you don't know what old is!Come back and tell me in about 40 yrs.
I have a huge beef with this for a couple of reasons...
First - We taxpayers paid for it not his health insurance - by virtue of his unAmerican "service" to country.
Secondly - He probably jumped to the top of the list over a "more" medically urgent patient.
Thirdly - This just allows him to continue to subvert the People's America for corporate USA.
I don't hate Cheney. I just don't want to pay for his insurance to get treatment. Why should I pay for him to get great state insurance when I have none? I would never be a donor. Middle income people should not be used as spare parts for the rich or well insured. If I get sick I die, but if others on medicaid, disability, and any other state insuance program get sick, I get to help pay for it. Yet these same people scream and yell tell me I should not have access to affordable insurance because it would take away from me giving them, for the most part, a free ride. What a great system we have here.
Time will come, sooner then you think, when you will not have a choice over being a donor or not. "Spare parts" will be recycled by law. So, cremation today = donor tomorrow. Cremation costs will go down, what's left can be ashed with a match....
Ah you all careing, all loving liberals do you ever read what you write?
do YOU ever read about the atrocities this man committed? there is no need to "care" for a murdering pos like this.
Yes; money and power are the way of the world and have been since the beginning of time. All of you who do not understand that please take a giant step forward......... still waiting.......... ok; so we ALL know that.
Next item up for discussion: would you get a new heart at 71 if you had billions of $$$ and the power to make it happen? Yeah, regardless of how you want to sound in this blog or on Facebook, the truth is nobody wants to die. Except fanatics who believe they are getting some kinda super-reward in an "afterlife" fairytale spun to recruit them. Hey Christians: I'm talking to you too...... can you say "Crusades?"
So: money = longer life. You might not like it but that's because you probably don't have the money to make it happen or you wouldn't be wasting time writing on this discussion comment page.
Darth Vader has a new heart...watch out, the Empire strikes BACK!