I agree with most advice given by the affable TV character Ted Lasso. "Every choice is a chance," he said. Pandemic-era physicians must now consider whether a politically motivated choice to decline COVID-19 vaccination should negatively affect the chance to receive an organ donation.
And in confronting these choices, we have a chance to educate the public on the complexities of the organ allocation process.
A well-informed patient's personal choice should be honored, even if clinicians disagree, if it does not affect the well-being of others. For example, I once had a patient in acute leukemic crisis who declined blood products because she was a Jehovah's Witness. She died. Her choice affected only her longevity.
Compare that decision to awarding an organ to an individual who has declined readily available protection of that organ. Weigh that choice against the fact that said protection is against an infectious disease that has killed over 5.5 million worldwide.
Some Institutions Stand Strong, Others Hedge Their Bets
Admirably, Loyola University Health System understands that difference. They published a firm stand on transplant candidacy and COVID-19 vaccination status in the Journal of Heart and Lung Transplant in January. Daniel Dilling, MD, medical director of the lung transplantation program , and Mark Kuczewski, PhDa professor of medical ethics at the Stritch School of Medicine, wrote that, "We believe that requiring vaccination against COVID-19 should not be controversial when we focus strictly on established frameworks and practices surrounding eligibility for wait-listing to receive a solid organ transplant."
