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Doctors, not vultures

The latest scandal involving an organ-transplant case may have been just a case of ignoring the rules.

March 03, 2007

THE SCANDALS THAT have rocked the organ-transplant system in recent months have pointed to the same recurring problems -- too few donors for too many waiting recipients, hospital bureaucracy jeopardizing patient's lives and transplant centers receiving oversight that is spotty and inconsistent at best.

The best thing you can say about this week's organ-transplant revelations, as reported by The Times' Tracy Weber and Charles Ornstein, is that if the allegations against a San Luis Obispo transplant surgeon are true, then for once the issue wasn't about a lack of clear rules.

Police are investigating whether Hootan Roozrokh tried to hasten the death of a would-be donor in February by giving him massive amounts of painkillers and sedatives, in violation of state law barring transplant surgeons from administering to still-living patients. According to a federal inspector's report, Roozrokh ordered morphine and Ativan for cardiac failure patient Ruben Navarro, 26, who had been on life support. Organs have a 30-minute window of viability between when life support ends and death; Roozrokh reportedly upped the dose once more in a last-ditch and failed effort, which was observed by at least seven people -- including three organ-transplant professionals -- who should have known better.

Ghoulish-sounding harvesting incidents can discourage donations. Yet the alleged violations in this case are so startling in part because they are also so rare. Many transplant surgeons refuse to even enter operating rooms while patients still live, in order to avoid the appearance of organ retrieval trumping patient care.

And there may be a surprising silver lining. When organ-transplant scandals erupt -- as they have persistently the past 18 months, at Kaiser Permanente, UC Irvine and elsewhere -- two things happen. The first is that more scrutiny is applied to the system. The United Network for Organ Sharing, the federal contractor that oversees the safety of the nation's transplant system, said Wednesday that it already had taken steps to ensure that violations similar to ones alleged in San Luis Obispo could not occur again.

The second is that \o7more\f7 people register to become organ donors, because the publicity reminds them that tens of thousands of peoples' lives depend on the altruism of donors. In California, people are joining an organ and tissue donor registry at a record pace: 5,000 a day.

Still, transplant professionals need to earn that public generosity, not repel it by practicing vulture-like medicine on the weak. End-of-life medical issues in this country remain complicated, emotional and expensive. But this case suggests that the rules were clear, just broken

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