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The Case Against

James Neuberger, MD

Arch Intern Med. 2003;163:1881-1883.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

IN A UTOPIAN WORLD, every person would get all the medical treatment required to maintain the highest quality and length of life. However, utopia means "no place," and the reality is that resources are finite, and tough decisions have to be made as to how these should be allocated. Even within the health budget, there are competing claims for scant resources. Despite the huge sums the United States spends on health care ($1.3 trillion in 2000—13% of the gross domestic product), resources are inadequate to provide for the needs of everyone. Even though liver transplantation is an expensive therapy (billed charges for a liver transplantation are about $290 000), it is highly effective in improving the length and quality of life.

However, with liver transplantation, the restrictions are not just fiscal; they are related to donor organ scarcity. The data from the United Network for Organ Sharing (UNOS) . . . [Full Text of this Article]

From the Liver Unit, Queen Elizabeth Hospital, Birmingham, England.