Why Was Anthony Stokes Denied A Heart Transplant At 15?


Yesterday, the story of Anthony Stokes — a Georgia teen in need of a heart transplant — hit the national media, shining a light not only on organ donation, but also the shadowy practice of donor lists and eligibility.

Anthony Stokes is just 15, and until three weeks ago, had never been ill in his life. Now Stokes has just months to live and faces dying before his life ever really began. And despite that, his mom says the hospital won’t even consider giving him a heart.

At first, much of the speculation blamed the teen himself for the “noncompliance” charge — many said that had Stokes taken his medication as he was supposed to, he’d be eligible for a heart right now. But under closer examination, that idea falls away because Stokes hasn’t been ill for very long at all, much less enough time to form an opinion he’d be unlikely to follow up with medical guidelines.

Can a 15-year-old minor child even be held to this sort of life and death accountability? On what criteria, barring a non-existent lasting illness, could medical boards be making a decision to deny Stokes a place on the transplant list in Georgia?

Quite scarily, a statement from Children’s Healthcare of Georgia indicates only that the facility is “continuing to work with this family and looking at all options regarding this patient’s health care.” A letter previously sent to Stokes’ family says that the consideration of a heart transplant for the minor child is off the table “due to having a history of non-compliance.”

Dr. Nieca Goldberg, a cardiologist at NYU Langone Medical Center in New York, spoke with Matt Lauer on TODAY this morning about the Stokes controversy. Goldberg said the decision to grant a heart transplant is generally predicated on medical history and likelihood of compliance with medical directives:

“What places you on the lower part of the transplant list is evidence that you haven’t followed through with taking your medications in the past… Research has shown that if you fail to take your heart failure medications before the transplant, you’re unlikely to take them after.”

But how could that be possible not only for a child who has only recently fallen ill, but also one that has no demonstrable history medically of medical protocol compliance? And even if that were the case, which it appears not to be, how could a 15-year-old (not 16, 17, or 18) be held to such a standard alone?

Stokes’ mother believes that her son is being treated differently because he had an ankle monitor during a hospital visit stemming from a punishment after a fight while he was healthy. The SCLC’s Christine Brown believes that Stokes has been stricken due to issues in school and behaviorally, but commented:

“There was a case with a guy named Larry Hagman who was a heavy drinker and received two livers. This child is 15 with no history of drugs or alcohol abuse.”

During the course of Anthony’s short but life-threatening illness, Brown says he has never indicated he is in any way not compliant:

“He has been in the hospital and has been very compliant. I don’t know how they can see he is not compliant. ”

Regarding the Anthony Stokes case, TODAY also quotes bioethicist Art Caplan — who “says that while compliance needs to be a factor in deciding who gets a transplant, ‘teenagers are almost noncompliant by definition.’ ” If that’s the case, why is Stokes being considered so differently?

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