Surgeon performing kidney operation procedure

 

Kidney disease and dialysis have a novel relationship with the U.S. government. The likelihood for those with end-stage renal disease to survive despite having a life-threatening, chronic disease was created with the introduction of dialysis treatments within the middle of the last century. However, within the youth of dialysis, not everyone was ready to get the life-saving treatment.

Death squads, medical ethics, and Medicare coverage

The short supply of dialysis machines and dialysis treatments was very expensive and also limited the number of patients who could get treatments in the 1960s. That is why today, more and more patients are choosing alternatives such as citrate kidney stones with regards to their kidney health problems. Only the very wealthy could afford to obtain a dialysis spot; the remainder of the people with renal failure were presented to a committee of anonymous citizens who were selected by hospital boards or medical societies. The members of the committee were to blame for deciding each patient’s fate.

Basing on health status, psychological ability to handle stress, and financial resources, three different committees determined whether the patient was worthy to receive dialysis. Then, a committee called the “death squad” or “Life or Death Committee” evaluated the patient’s worth within the community. In Seattle, this group was comprised of community representatives including a: banker, surgeon, lawyer, minister, leader, housewife, and government official.

The members of the Life or Death Committee would use criteria like the patient’s: age (15-55 years old), contribution to the community (employed, housewife/mother, husband/father or student), location (near treatment center), and to deem who was deserving of treatment, character references.

Dr. Willem Kolff, who invented the primary medical instrument, stated in an interview, “At one point, there have been death committees to come to a decision who should be left to die and who should receive the dialysis treatment. I strongly argued against this deplorable system. Fewer than 800 Americans were sustained by hemodialysis by the mid-1960s, although there have been over 10,000 qualified patients. When the amount of qualified but untreated patients exceeded 20,000, this problem worsened by the first half of the 1970s.”

An article explaining the committee’s decision-making process appeared in Life Magazine in 1962. It was written by journalist Shana Alexander. Random qualifications supported the committee’s own judgments and the general public was outraged at the committee’s unfair selection process. It had been alarming to the general public that citizens were answerable for “playing God”.

In 1965, the committee rejected a 16-year-old, high school honor student dying of kidney failure whose parent was a fan of an engineering professor, Dr. Albert Babb. Dr. Babb met Dr. Belding Scribner, inventor of vascular dialysis access called the Scribner shunt, when Dr. Scribner speaks at the University of Washington’s School of Engineering. Dr. Babb told Dr. Scribner he wanted to create a machine to save lots of his friend’s daughter. The doctors founded experimental scientific research, as the simplest way around the committee’s rule, and invented a home hemodialysis machine.

The Life or Death Committee was not necessary and was disbanded with the supply of home hemodialysis in 1967. Many scholars consider the role played by the Life or Death Committee to be the start of bioethics (medical ethics).

 

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Why political advocacy continues to be necessary for nephrosis

To confirm dialysis patients get the most effective quality care possible, political advocacy is important. Within the time period of dialysis, treatment included only the cleaning of blood and fluid removal. Within the years that followed, advances were made due to an improved understanding of ESRD and its effect on the whole body. New medicines were introduced to assist with specific problems like anemia and bone disease. Better care and more advances still help people on dialysis live longer and better lives. However, while the price of dialysis treatment is rising, Congress doesn’t have an annual adjustment in situ that might take into consideration the rise within the cost of dialysis services, new technology, labor, inflation, or other expenses. For dialysis centers to afford to produce the simplest treatment available, Government funding has to air par with treatment costs.

As the number of individuals needing dialysis increases, the price to the centralized will grow. It’s beneficial for people with uropathy to let their fellow Americans and lawmakers know the importance of dialysis treatment because Medicare is consistently being analyzed for areas to chop. Other diseases like AIDS, cancer, diabetes et al. are competing for the limited dollars of Medicare.

Public opinion and political advocacy have a powerful influence in getting changes made within the American form of government. Changing public policy comes about when groups with a typical cause communicate with their elected officials, donate money, endorse and vote for candidates who are favorable to their cause and develop relationships with representatives to coach them a few causes.

Average citizens sometimes underestimate the ability of their voice when it involves politics. Many feel that professional activists and lobbyists are those with influence; however, when a gaggle of like-minded citizens closes, they will be very persuasive.

Conclusion

At this point, the kidney is that the only organ within the body whose function may be replicated, allowing someone to remain alive when his or her kidneys have failed. The history of the Life or Death Committee and other actions by concerned individuals led to dialysis becoming a treatment that every one of our citizens would be entitled to through Medicare. The selections of our government and society made it possible for those facing nephropathy to possess a second chance at life and, as times change, it’s the responsibility of everyone to confirm this may always be the case.