Thomas D. Overcast

Patient Selection for Heart Transplantation: When Is a Discriminating Choice Discrimination?

Section 504 of the Rehabilitation Act of 1973 prohibits discrimination against the handicapped in any program receiving federal funds. With its implementing regulations, Section 504 may well apply to the selection of patients for medical treatments. This article examines patient selection for heart transplantation, in light of the Rehabilitation Act and its previous application in similar (but non-medical) contexts. With the growing need to allocate scarce medical resources comes a need to examine carefully the legal bounds for patient-selection procedures.

Technology Assessment, Public Policy and Transplantation: A Restrained Appraisal of the Massachusetts Task Force Approach

T h e February 1985 issue of Law, Medicine &Health Care published excerpts from the Report of the Massachusetts Task Force on Organ Transplantation,’ along with a report by its chairman, Professor George Annas? and commentary by a number of esteemed scholars and practitioners3 who were generally complimentary of both the approach and substance of the work of the Task Force. We have thoroughly reviewed the Task Force Report and feel it necessary to take strong exception to a number of points, both procedural and substantive, raised there. In general, we are concerned that the Task Force Report perpetuates and reinforces a number of serious misconceptions about the issues surrounding transplantation that, in turn, lead to conclusions that are both inaccurate and misleading. This situation is most unfortunate because the complexities of the issues raised by transplantation require care-