Greetings,

The committee members have decided to look at some outside articles related to the issues in Mr. F’s case.  They just want everyone to develop a deeper understanding of the problem. Please take a look the articles below, which some of the committee members selected.

Articles:
Liver Transplant: No Methadone Users Need Apply, Please

Liver Transplantation for Methadone-Maintainted Opiate Dependants: Making the Case for Cautious Optimism

Liver Disease in MMT: Treatment and Transplant (Read pages 1-3)

Addiction as Disease

Using these articles as input, please write up your understanding of the arguments for and against granting transplant approval to a methadone patient.  When you do this, consider the following:

• The issue of drug addiction as a disease and how this disease may negatively influence the success of a transplant.


• The ramifications of denying a transplant to a patient who appears to be successfully controlling his addiction.

Again, remember it’s not just Mr. F we’re talking about; we're setting policy.  Also keep in mind that at this stage in the process you should reserve making any judgment.  Rather, you should be looking to uncover any new important factors that could impact your judgment, or to better understand the ones you’ve already listed.

Your Task
Our hope is that by considering our scenario in a broader context and considering some other opinions, we can develop a deeper understanding of the core issues surrounding Mr. F’s case. I have attached a template to help you organize your ideas about each article. As you are reviewing the articles, consider the following:

• How does the article address one or more of the problems we are dealing with in this case?
• Does the author offer an opinion on how to handle the problem?
• Does the author offer any new information about this topic that might influence your ultimate decision? Does s/he suggest anything you haven’t thought about before?

I look forward to your thoughts on this material.

Sincerely,
Chris Jones, M.D.
Chair, Ethics Committee
Lincoln Regional Medical Center