God Committee Vs Unos
Allocation of scarce medical resources is an on-going dilemma in the healthcare industry. Trying to find the most fair, objective way to allocate these resources is a challenge but outlining a structured approach to allocation can help relieve some of the burden of this decision. The process has evolved significantly since “the God Committee” was created at Seattle’s Swedish Hospital to determine who was to be entitled to the lifesaving treatment, hemodialysis (Levine, 2009).
While there are many concerns about the God committee, one of the major contrasts with that of UNOS, is the makeup of the committee versus the policy setting board of UNOS. Notwithstanding the multiple committees that support the board, the majority of the members
are medical professionals, individuals with medical, legal, nursing and public health degrees (United Network for Organ Sharing, 2015). Conversely, the God committee was made up of 7 people, only one being a medical professional.
Another major difference is the criteria used to select candidates. Notwithstanding the preselection done by the physicians, the committee considered several social determinants in recommending candidates for participation. Although one might argue the ability to recover from the surgery and return to an active lifestyle was a valid criteria, it appears they valued factors such as number of children, marital status, wealth, and professional value (Alexander, 1962). Accordingly, the UC Davis Transplant Center refer strictly to health factors that have direct correlation to viability of organ donation and ability to recover such as smoking, BMI and drug use (UC Davis Health, 2017).
Nevertheless, the decisions the committee made do seem to have had positive outcomes and they did avoid any issues of wealth manipulating the decisions, a major concern even in today’s efforts to improve any process for reallocation (McGuire, 2016). One constant goal is to make sure the decision is being made correctly even if the end decision may not be the correct decision (Singer & Mapa, 1998).
While there are many concerns about the God committee, one of the major contrasts with that of UNOS, is the makeup of the committee versus the policy setting board of UNOS. Notwithstanding the multiple committees that support the board, the majority of the members
are medical professionals, individuals with medical, legal, nursing and public health degrees (United Network for Organ Sharing, 2015). Conversely, the God committee was made up of 7 people, only one being a medical professional.
Another major difference is the criteria used to select candidates. Notwithstanding the preselection done by the physicians, the committee considered several social determinants in recommending candidates for participation. Although one might argue the ability to recover from the surgery and return to an active lifestyle was a valid criteria, it appears they valued factors such as number of children, marital status, wealth, and professional value (Alexander, 1962). Accordingly, the UC Davis Transplant Center refer strictly to health factors that have direct correlation to viability of organ donation and ability to recover such as smoking, BMI and drug use (UC Davis Health, 2017).
Nevertheless, the decisions the committee made do seem to have had positive outcomes and they did avoid any issues of wealth manipulating the decisions, a major concern even in today’s efforts to improve any process for reallocation (McGuire, 2016). One constant goal is to make sure the decision is being made correctly even if the end decision may not be the correct decision (Singer & Mapa, 1998).