The premise
IN the season finale of ABC's "Grey's Anatomy," one of the surgical interns, Dr. Izzie Stevens (played by Katherine Heigl), crosses an ethical line by becoming romantically involved with a potential heart transplant patient, Denny Duquette (played by Jeffrey Dean Morgan). He has signed a Do Not Resuscitate order, but Izzie gives him hope that he will get a heart in time.
When two brothers are mortally injured in a car accident, it seems as if Denny will get a heart. Unfortunately, one of the hearts stops beating, is immediately deemed unusable, and the other brother's heart is designated for another potential recipient who was placed on the list before Denny (by 17 seconds).
Izzie then deliberately cuts the pump lines of Denny's heart's left ventricular-assisting device. Emergency cases get priority, and his deteriorating condition will move him up the transplant list.
But Izzie's disconnection of Denny's assistance device (which initially caused the heart to stop) ultimately leads to his kidney failure.
The other surgical interns learn what is happening, but they don't report Izzie's behavior to the supervising resident.
When the truth comes out, the chief of surgery acknowledges that the hospital's accreditation may be in jeopardy, but he takes no action and Izzie quits on her own.
Because of his worsening heart failure, Denny receives the heart that was intended for the other recipient, but dies afterward.
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The medical questions
IS the heart transplant list so competitive? Is a prospective candidate allowed to sign a DNR order before surgery? Are interns so unsupervised that they are in a position to disrupt an emergency heart pump? Wouldn't such a horrific event be cause for immediate arrest and discredit the training program? Is it realistic that if a donor's heart stops, it is immediately rendered unusable?
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The reality
THE jockeying for a heart transplant is very competitive, and a patient's position on the transplant list -- in addition to the severity of his or her condition -- determine the order. However, a prospective heart transplant patient would never sign a Do Not Resuscitate order -- surgeons would not operate on such a patient because resuscitation may be necessary at any point.
Second, if a heart assistance pump were disconnected, a loud alarm would sound.
