Atlanta teen who received controversial heart transplant dies in chase with police

[Crabby Appleton]

Source: WAPO

In 2013, then-15-year-old Anthony Stokes was dying and desperately needed a heart transplant that he couldn’t get because, according to doctors, he had “a history of noncompliance.”

Stokes’s family suspected that his low grades and a history of trouble with the law gave doctors reason to believe that he would not be willing to take his medicine or show up at subsequent doctor’s visits. The Georgia teen’s story story sparked outrage, and the hospital quickly reversed their decision, giving him priority on the transplant list.

But two years later, after he received a transplant, it appears that Stokes’s “second chance” has come to an abrupt end.

more at link...

Read more: http://www.washingtonpost.com/news/morning-mix/wp/2015/04/01/atlanta-teen-who-received-controversial-heart-transplant-dies-in-chase-with-police/

[Journeyman]

1. The article doesn't say, but I wonder if they were able to harvest his heart . . .

He didn't use his second chance to great effect, but perhaps another might better profit from it.

[Ms. Toad]

9. Not likely.

Occasionally a heart can be re-used shortly after transplant, if the death is unrelated to the transplant - but this is likely too long after.

Other organs could likely be used.

[Journeyman]

10. Interesting. I'll have to do some reading on that. It doesn't surprise me. . .

that the heart can't be swapped out limitlessly like a 4-barrel carburetor, but I am surprised that there is a window of opportunity to re-use it, a time when a second transplant could be accomplished, but also a limit on when it could be done.

[Travis_0004]

45. Not after a high speed accident

Too much internal damage to the organs.

Also the body would never make it to the hospital soon enough. They have to investigate the scene of the crash before they pull the body fron the wreckage. I will assume the odds of that heart being reused are a solid 0 percent

[Journeyman]

53. The article says he died at the hospital, so a second harvest seemed a possibility . . .

[LisaL]

80. No, it's not.

Nobody is going to transplant the same heart twice.

[LisaL]

79. No. The heart can not be re-transplanted.

[Warpy]

85. No, there are two types of rejection

One happens quickly if noncompliant people don't take their drugs and it kills quickly.

The other kind is slower and over a period of years, will harden the arteries and stiffen the muscles and the person will go into the type of heart failure that provoked the transplant and die.

The transplanted heart this kid got is likely quite damaged.

[KamaAina]

2. Haven't the cops learned their lesson about high-speed chases??

[Rebubula]

23. LOL

Kid carjacks, home invades and shoots at an elderly woman.....and it is the COPS fault?????


OK...

[KamaAina]

25. No, but the tragic end is

I'm pretty sure he could have been taken alive. Many departments have policies against high-speed chases for precisely this reason.

[Hassin Bin Sober]

27. I'm pretty sure that's for minor traffic offenses and minor violations.

I think all bets are off when they are after a possible home invasion shooting suspect.

[Reter]

28. He never should have gotten the transplant to begin with

If he hadn't, no high-speed chase.

[Sparhawk60]

46. This, One Thousand Time

I wonder who died becosue this person got the heart that other wise would have gone to some one else?

[Travis_0004]

34. Meh

Its not the police fault he was an idiot an ran into a pole.

[KamaAina]

36. He ran into the pole DURING the chase.

Ideally, he gets pulled over a few miles down the freeway and surrenders.

[XemaSab]

39. He also ran over a pedestrian

Are the cops responsible for that, too?

[Travis_0004]

44. Im aware of that

I just dont care. He choose to drive reckless and actions have consequences.

[Blue_Tires]

3. Wow...Way to piss away a second chance at life

(assuming the AJC account is accurate)

http://www.ajc.com/news/news/roswell-pd-fleeing-burglar-shoots-at-victim-hits-p/nkjdM/

[bluestateguy]

12. There are times when it's best to just let the car get away

As it can be more of a threat to public safety to engage in a high speed chase than to just let someone get away who stole a pack a cigarettes from a drug store.

Although I don't know what the circumstances are here.

[EL34x4]

13. He shot at an elderly woman during an attempted burglary.

Yes, I know it's the "Daily Mail" but still...

[link:http://www.dailymail.co.uk/news/article-3021384/Heart-recipient-17-dies-high-speed-police-chase-crash-two-years-nearly-denied-transplant-bad-behavior.html#ixzz3W4V5EuwP|

[bluestateguy]

14. Ok, that's obviously a case where you would pursue

Like I said, I wasn't aware of the facts here.
But if someone is just ditching the cops over a minor crime, just get the liscence plate number and let them get away. radio in for a road block if need be.

[Reter]

30. He would have eventually ended up killing someone

He had a long history of violence. A life ended, but at least one was saved.

[Corey_Baker08]

67. Unfortunately, This Was Not One Of Those Instances

Its amazing how some on here always find a way to try to blame the police for absolutely everything no matter how cut & dry...

btw bluestateguy, I am not singling you out in particular in my comment about Police being blamed, it goes to the entire thread...

[jtuck004]

4. Didn't Dick Cheney get a second chance with heart surgery? And look what he did with it. n/t

[Daemonaquila]

21. Thank you.

Sad that people are judging this kid whose mistakes and crimes could never begin to equal those of Cheney (and others who've received organs).

[Judi Lynn]

22. He's a true reason to NEVER agree to become an organ donor.

You could be passively connected to torture and murder of thousands, and the destruction of millions of lives.

[Beacool]

5. He was given a second chance at living and he wasted it.

There's such a great need for organs and he was given the gift of life when many others don't get that chance. Pity that he wasted that opportunity and the heart that could have been beating right now in someone else's chest.

[Helen Borg]

6. Many people change their life...

When they have a close encounter with death, that is true. Unclear if he tried and failed, what happened exactly in his life. Sad.

[seveneyes]

19. Unclear if he tried and failed?

Nobody has to "try" to keep from robbing, shooting at their victims and then endangering innocents at high speed in a stolen car.

Nothing unclear at all about this individual's failure.

[Mugu]

40. Hear, hear!!!! n/t

[Warpy]

86. I knew a kid who got one and everybody said it was a waste

Ten years later, he was doing well, a professional musician. I'd say he was a total success story. He was not only taking care of his heart, he was having a blast with it.

Not everybody chooses to live the same sort of life. Yes, this heart would likely have lasted longer in a more responsible person. This kid should have been off the transplant list if he had flunked the psychological testing. I suppose that at the time, there was no other close enough match for the heart that became available.

[Ms. Toad]

7. There are screening guidelines for a reason.

I know I sound like a broken record, but there are fewer donated organs than there are people who need them. People die on the waiting list every single day. The best predictor for compliance post-transplant is your behavior when you are most needy (i.e. when the threat of death is real). If you can't get your act together to demonstrate your ability to comply then, the likelihood that you will be able to do so one the threat of death is no longer real is smaller than for someone else who has been able to demonstrate compliance.

Someone else may well have died because this child was (apparently) granted an exception to the rules.

No matter how unfair they may seem, the selection of who will receive the organ is best made based on tested predictors. Sometimes that means people like Stokes don't get a heart - and people scream prejudice. Sometimes that means people like Cheny get a heart and people scream that money buys organs (the reality is that Cheney was on the waiting list for a heart in his region far longer than average - I've checked against the wait list in the region where he received his heart on the dates in question). Tweak the rules, if one turns out not to be as predictive as once thought - but don't just ingore them for the sake of appearance (as seems to have been done in this case).

[Gormy Cuss]

11. There is nothing in the link however that says he didn't comply with the medical requirements.

For all we know he may have done everything required of him up until his last day. That he probably died as a still juvenile criminal would in that case be irrelevant to whether he should have received his transplant.

[Ms. Toad]

32. Not at that link, but a different source

reports he was using marijuana. (Also) Marijuana use post-transplant, at least to the extent it does not come from a legal and medically controlled source, which test for contaminants, is prohibited by all transplant centers. It is prohibited, in part, because it is risky to people with immune compromised systems because when not tested for contaminants, it can contain Aspergillus (below the pictures is a general discussion of aspergillus and marijuana). Aspergillus can cause serious, life-threatening ilnesses in people with immune compromised system.. http://www.itns.org/uploads/ITNS_Heart_Transplant_Booklet.pdf

Not to mention that all drugs, illegal or not, carry the risk of interference with the anti-rejection drugs and must, at a minimum, not be used wtihout the consent and approval of your transplant doctor.

So not only did he continue the behavior that created the concern he would be non-compliant in the first place, he actually was non-compliant post transplant - and that knowledge comes from information not protected by HIPAA. I have no idea what might be in his actual medical records.

[Gormy Cuss]

43. Noncompliance is more common in adolescents. Does this mean they should be skipped on the list?

Noncompliance is higher for patients with less than 13 years of education. Does this mean that people with only high school diplomas should be bypassed in the transplant queue until the college grads have organs?

Noncompliance is higher in patients with weaker social networks. Does this mean that loners should be moved to the bottom of the list?

I realize that there is a shortage of organs but the whole discussion about who's worthy and who isn't must not be blind to biases introduced by the screening process.

[Ms. Toad]

47. The reality is that some of those likely play an indirect role, because noncompliance

Last edited Thu Apr 2, 2015, 10:58 AM - Edit history (1)

results in not just one - but multiple deaths. The person to whom the organ was given dies, as well as one or more people on the waiting list who would have lived but for the lack of the organ they needed.

The former plays no formal role in being listed, nor should it. Stokes's problem wasn't that he was a teen without a high school diploma. It was because his history demonstrated an inability to comply with what will be a strict medical protocol he would have to follow for the rest of his life, judged partly by his inability to follow medical or other behavioral protocols at the time he was being evaluated for being listed.

For very young children, it is their parents' ability to manage a strict protocol that will be evaluated as part of being listed.

I know at least a dozen child transplantees, some of them pretty wild and crazy teens, some of them far from the brightest bulb in the planet, some of them whose families were poor enough to be on public assistance. And I know an adult heart-lung recipient who would have failed based on several of the predictors you have mentioned. But each of them (or their parents) was able to demonstrate what Stokes was not - an ability to remember and attend medical visits, an ability to live with the kind of external controls living with a donated heart imposes on your life.

As for weaker social networks and going to the bottom of the list - once you are listed, there is no non-medical "bottom of the list." You are listed, or not. Once you are listed, what determines your place on the list is matching criteria, predicted survival time without an organ, and geography. But to be listed, you don't have to have a strong social network - but you do need to demonstrate an ability to survive short term - which typically means you need to have at least one person who is willing to provide support (and do the things you will be unable to do for yourself) during the period shortly after transplant.

But the criteria you have listed do not play a generic role, nor should they. They only play a role to the extent they result in behaviors - or a lack of access to a short-term support system during the critical care period - that are predictive of a likelihood that the organ will be wasted because the recipient was unable to do what is medically necessary to care for the organ that, properly cared for, would have saved someone else's life.

Getting on the list has NOTHING to do with who is worthy. Getting on the list has to do with passing a threshold which demonstrates that you have at least the minimum ability necessary to be a good risk to properly caring for the organ. Once you are on the list (absent demonstrating that you no longer meet the threshold), the decision of who gets the organ is purely matching criteria, predicted survival time without an organ, and geography.

Stokes failed the first step - meeting the minimum threshold. That decision was apparently, inappropriately, overridden because of social pressure and now not only is he dead, but likely another person who actually met the threshold because they did meet the minimum threshold but the heart was given to Stokes because he was (at the time) more medically needy.

This is not theoretical for me. I personally know 2 individuals who died within the last year on the waiting list (or because the liver came too late to save them), and many more who died in prior years - and, of course, many who received the organs they needed. I don't begrudge livers going to people whose own livers no longer function because of past behavior - even though that criteria might ultimately mean my own daughter dies because one of them is given a second chance. But the second chance isn't without strings - it requires (in the case of livers) a 6 month period of demonstrating that you have changed your life before you can be listed. Staying free from alcohol for six months when you are scared for your life is not necessarily a long term predictor of success - but it is a threshold. If you can do that much, you have a reasonable chance of succeeding. I would be furious if social pressure to avoid appearing biased put people on the list who could not even manage that minimum 6 month period of sobriety. If - when you are scared for your life - you can't manage to refrain from alcohol for 6 months, the likelihood you will be able to do it for a lifetime is virtually zero. And my child, who is a tee-totaler, and has been perfectly managing her own complicated medical regime since she was around 10 might die because it looked - to too many people - like a behaviorally predictive decision was driven by social bias.

[riderinthestorm]

49. Jinx!

posted at pretty much the same time...

[Ms. Toad]

50. :)

[Gormy Cuss]

60. I selected those noncompliance risks from one study. Other studies refute the education marker.

So until there is agreement on what factors contribute to noncompliance, all of these (or none of these) should have much weight in the decision because it's little more than reading tea leaves. Should he have been put on the list? In hindsight it looks like the predictive screening got it right in his case. The same screening however misses the mark with others who have also been noncompliant and died.


Stokes lived 20 months post transplant. Before the transplant he had an estimated 6-9 months to live. Thus the heart transplant was a success in that it extended his life.

[Ms. Toad]

75. You are looking at a study which typed people,

not behavioral characteristics (based on what you have quoted), and not the actual screening process. No real listing process excludes people who are teens (as a general category), or who have not graduated from high school (as a general category).

The point is not that it successfully extended his life - it is that putting him on the list when he was so clearly unable to comply with external restrictions on his behavior (no illegal or non-medically supervised drugs, regimented medical routine, compliance with health care) likely cost someone else their life.

There are far more people who need organs than there are organs to give that it is unethical to give those organs to people who have demonstrated by their behavior that they do not have a minimum ability to do what is necessary to care for them.

[Ms. Toad]

84. BTW. It was not "hindsight"

An Atlanta teen with an enlarged heart is not being placed on the transplant list because he has had behavior issues in the past. Anthony Stokes, 15, has only six months to live but, because he failed to take his medication in the past, doctors at Children's Healthcare of Atlanta have stuck him with a “noncompliance” tag.

http://www.opposingviews.com/i/society/atlanta-teen-anthony-stokes-denied-spot-heart-transplant-list-non-compliance#

He had a demonstrated, and very specific, history of medical non-compliance - which people who do not understand what is involved in maintaining a transplanted organ ridiculed as a front for "bad kid."

(Retrieved from the earlier thread - before his transplant - in which I made essentially the same points I have made in this thread)

[forsaken mortal]

87. academics

There are lots of bad reasons kids can get bad grades that have nothing to do with intelligence or diligence (abusive parents, poverty, mental illness, millions of other things.) Using grades as a criteria for medical treatment isn't a path I want to see this country walking.

[riderinthestorm]

48. The screening process doesn't lump people into categories like you are doing

every individual is evaluated individually.

They get accepted or not on their own merits. There's no bias on the part of the selection committees. This boy had compliance issues before hand. He obviously failed at compliance afterwards and has paid the ultimate price as did someone else who did not get that heart.

Other children succeed where this one failed because they demonstrated they were responsible and compliant.

Fyi, my sister has a transplanted kidney and liver. As her main support person through the process start to finish, I was there for every part of the procedure and met many, many transplant survivors. Feel free to ask me anything. Ms Toad is similarly well versed and has done an excellent job educating on this thread.

[Yo_Mama]

52. Smoking is non-compliance, for obvious reasons. A smoker will not get a heart transplant.

http://www.ajc.com/news/news/tragic-path-for-heart-transplant-teen-given-a-seco/nkkSG/

Based on Stokes’ recent Facebook posts and numerous selfies, the teenager was headed down a path that was destined to end in tragedy. Photo after photo posted by Stokes shows a thin, young man that looks younger than his years, except for a small goatee and tattoos. In many pictures, Stokes has photographed himself pointing a handgun, holding cash and smoking.

The public, which was very supportive of Stokes, did not know the extent of his behavioral issues at the time. Also from the above link:

DeKalb Police arrested Stokes 11 times between 2010 and 2015, said Capt. Steve Fore. The charges included burglary, auto theft, weapons charges, terroristic threats. He had a burglary and truancy charge in 2010 as well as another burglary charge of a home in December 2012 and he picked up another burglary charge in February 2013, six months before the transplant controversy erupted, Fore said.

In April of that year police stopped a Tahoe with Stokes and two other teens because someone complained the group had fired a gun several times after a disagreement. The arresting officer found two stolen pistols and also arrested Stokes for an outstanding arson warrant, the report said.

It's not a matter of being "worthy" - none of us is worthy of a gift that can only come through the death of another. It's a matter of being reasonably likely to keep that gift by following the rather restrictive lifestyle necessary to do so.

The reality is that someone else did not receive that chance because this boy did, and based on the information we now know, he never should have received it - not because he was unworthy of life (he was only a kid!!), but because he just didn't have the behavior patterns that go with the ability to take the medications precisely as ordered, keep the appointments, avoid the risks, and follow the type of lifestyle required for transplant patients.

Read the article. Stokes seems hardly to have paused in his criminal career. He probably wasn't jailed in a juvenile hall only due to medical concerns, but in the end he would have lived longer if he had been. But I suspect he knew he was on borrowed time and wanted to get all he could of life while he still had it.

This story is nothing but tragedy and sorrow. A person so disrespectful of the life of others probably is incapable of protecting his own.

The reason why this is a public issue is that the guidelines were violated, and it didn't turn out well. All those who were advocating for him (I was one), killed another person who would have had a better chance than he did. That's the truth.

[Gormy Cuss]

55. That was not in the OP link

and yet some here were already assuming that Stokes was noncompliant because of the controversy before his transplant.

If his criminal conduct is relevant to the discussion, then it is all about him being unworthy.

I do agree with however that this story is a tragedy because Stokes was a kid who may have had a long life ahead of him thanks to the transplant. I disagree that this is a public issue however. The transplantation guidelines don't stop all risk of noncompliance. Thus, had this heart gone to another person there was STILL the risk of noncompliance.

[riderinthestorm]

58. Stokes was non-compliant before his transplant. We know that

Because the transplant team said so. Because of HIPAA, the med team won't disclose what factors came into play on why he was initially not put on the list but the usual culprits are failure to adhere to the rules during a several months long evaluation.

It's imperative that only those who are demonstrably compliant receive transplants. They're just too rare. Stokes got the heart because of public pressure which meant the other recipient did not. Though we don't know if the other patient would have been more compliant, it's now a 100% certainty that Stokes wasn't and the med team correctly called this one at the beginning of it all.

[Gormy Cuss]

62. And when the med team calls it incorrectly and denies a spot on the transplant list, we won't know.

Sure, it's easy in hindsight to say the screening made the right call on Stokes. What if instead Stokes had been uber-compliant and enjoyed a long life with his new organ? Wouldn't that prove that the screening process is deficient? As it is, there's some percentage of patients who pass the evaluation, have a successful transplant, and become noncompliant anyway so it would follow logically that some who were screened out would not have been noncompliers.

Ethically speaking, the screening process should be held under constant scrutiny to ensure that the factors used to determine eligibility are as free from external biases as possible. If the current system data could prove that Stokes was denied on bases that had nothing to do with his race or socio-economic status they wouldn't have to cave to public pressure.

And finally, I sincerely hope that I live to see medicine advance beyond needing donor organs to solve organ failures.

[riderinthestorm]

64. The screening process is under constant scrutiny lol!

every time someone is accepted and/or rejected and that placement (or lack thereof), the med team meets to go over the system again to guard against flaws. Every time.

And yes, the doctors who make these decisions are human. Subject to all human infallibilities and mistakes. While a persons MELD score is paramount, other things can factor into the decision.

For example, my sister is the director for a county mental health department in CA. She has her masters in psychiatric nursing and an MBA. Besides her ability to pay for the transplant and recovery (oh yes, $$ plays its part), her medical experience also played its part as well. Compliance issues, non-smoker, no alcohol, licorice and other forbidden foods within the past six months etc. these are all typical factors in deciding who makes the list. My sister looked like a great prospect right?

However for HER and her transplant (she got it at Cal Pacific Medical Center in SF) for that transplant center they assign a lot of points on the quality and strength of the support team. Our education, commitment, availability (you have to reside within 1 block of the hospital for at least a month post-transplant almost always longer because of fiddling with the anti-rejection meds) which meant we had to rent an apartment for 3 months in the heart of the most desirable part of SF and agree to stay there with her the entire time. Big $$ and commitment for us as well.

[Gormy Cuss]

65. Why the LOL if you agreed with that point?

Recognize that I am not arguing that screening should be eliminated, just that the screening should be as free of external biases as possible.

But on a related note, is it ethical to require patients to be able to self-support in a dwelling within one block of the transplant center? I'd say no. I'd also say that income and wealth are subtle ways that the screening process is biased. Moderate income people have a much harder time with such stipulations and it's a damn fact that some racial and ethnic groups are less likely to have those resources than whites. Does the ACA address this bias? Does the transplant community?

[riderinthestorm]

71. I'm sorry, I just had a chuckle at thinking the process isn't reviewed regularly.

its such a bone of contention, especially with cases like Anthony Stokes and Dick Cheney that garner a lot of media attention, it just seems obvious to me. But I digress.

It's imperative a post transplant patient stay nearby in case the early stages of rejection occur - they can reverse that but only if its caught immediately. It would be unethical for the doctors to let a transplant patient go home! My sister had to take her temp and weight twice a day and record it. If she deviated at all. At all! She was to immediately go to the hospital its that tricky.

The transplant community and the transplant centers spend a lot of time finding funding for those who qualify in every other way but who can't afford the procedure. There are foundations and other organizations that assist with this - even special medical bank loans. No one is turned away who can't pay (my sister and I had a 3 hour financing conference as part of her evaluation and I asked that question because frankly I didn't know if my sister could afford this). How this works with the ACA laws isn't clear to me. My sisters transplant was before the ACA.

As for the post-transplant meds cost, my sister was on 10 different meds at first - hugely expensive but she had insurance. That does taper down to 1 or 2 by the end of the first year in typical cases so the cost becomes more manageable but that initial drug protocol costs a lot. I'd guess there are also programs to cover these costs initially. I didn't ask that kind of follow up question with the finance director because by then I already knew my sister had both the funds and the insurance. The transplant teams want high success rates so the social workers are an imperative part of each team to ensure patient success. They aren't going to have a patient get the procedure only to die because they can't afford the anti-rejection meds.

[Yo_Mama]

88. They couldn't say why he was a bad candidate due to privacy laws.

Protecting juveniles and protecting medical information.

So they had no chance to argue the case, and if they had, they would have won public opinion.

So either you accept the decisions of the panels who set up the criteria and make the decisions, or you allow disclosure of the criteria used when going to the court of public opinion. Otherwise, it's all just bullshit.

I don't know the answer.

[christx30]

61. But another person may not have

shot an old woman and got killed by the police during a chase.
Stokes seemed to have very little respect for anything. Not other people, not for the person that died that gave him the heart. Not for the law. And, above all, the person who was passed up for the transplant and died as a result. His past criminal behavior was an idication for that lack of respect, and I believe should have been part of the selection criteria. If he hadn't gotten shot by the cops, he would have died as a result of organ rejection due to his lack of compliance. Nothing he did was accidental. Everything that was wrong with him was 100% up to him to fix. And he failed. The heart should have gone to someone else.

[Gormy Cuss]

63. You can not say that an adolescent with criminal behavior wouldn't change as he matured

and after going through a major life-altering event like being told that his heart was bad and he needed a transplant to live. In hindsight, we can say that Stokes didn't learn from it but that doesn't mean that other, similar adolescents would have had the same outcome.

[EL34x4]

66. No you can't, however...

The people charged with deciding who will receive transplants are quite literally sentencing others to death. Do they continue giving transplants to kids like Stokes, hoping they mature, clean up their acts and defy the odds or do they go with someone who has already demonstrated a record of compliance and following instructions?

The practice of transplanting organs is very much a zero-sum game. The gift of life to one person means it is being denied to another. And the person denied will die.

[christx30]

68. I wouldn't have given him the heart

knowing his criminal behavior before the transplant. Again, his background shows a lack of respect for anything. I never acted like that when I was a teenager. I didn't smoke. I didn't drink. I wasn't a great student in high school, but I wasn't involved in drugs or guns or all the crap he did. Those were choices he made. And when he got the heart, a second chance at life, he didn't treat it with the respect it deserved. I, for one, would have been grateful for the time had I been his age. Again, it's the lack of respect, and his selfishness.
The transplant team made the right decision initally when they actually looked at him and determined that he wasn't a good match. But public outrage got the hospital to change their minds. They should have stuck to their guns, gave the heart to a better person, and took their hits.
And finding out his heart was bad and he needed a transplant didn't seem to mature him at all. As soon as he got out of the hospital, he was back to his normal criminal ways. And now that heart is gone forever. A total waste.

[Ms. Toad]

78. He should not have been put on the list at the time.

Yes, he might change - but just like an alcoholic who is prohibited from being listed within 6 months of getting sober, Stokes needed to demonstrated for an extended period of time that he had changed BEFORE being listed. Yes- given the prediction of how long he had to live without a transplant, he might have died before being listed (or receiving a heart). As do many alcoholics who discover, too late, that their liver will no longer sustain them long enough to be listed.

If your behavior, at the time it is determined you need a transplant, demonstrates you cannot currently be compliant with restrictions externally imposed restrictions, you must demonstrate that you can change. If you cannot - either because time runs out or because you are not able to sustain changed behavior - the organ needs to go to someone with a demonstrated history of being able to be compliant.

[Ms. Toad]

77. Criminal behavior does NOT make you unworthy. It DOES demonstrate

an inability or unwillingness to comply with external controls on your behavior - which you will have to do as a transplant recipient for the rest of your life.

[Ms. Toad]

76. Thank you.

If you look at the dates of the entries on his facebook page, and the behavior exhibited in the photos there, I can't tell there was a pause at all.

And the issue was not just smoking, but smoking marijuana - a particularly risky activity for immune compromised patients (unless tested for contaminants), because it is known to commonly be contaminated with aspergillus - which can cause a life-threatening disease in people who are immune compromised (which all people are, who require anti-rejection medications post-transplant).

[dolphinsandtuna]

15. Ms. Toad is right

That was my first thought; someone else could have received that heart and lived, but instead they died because of public pressure to not comply with reasonable guidelines.

If there were an oversupply of hearts, give them to anyone regardless of what you think they'll do. When there's an undersupply, wasting them is indefensible.

[blackspade]

8. :(

[dembotoz]

16. the thought of having to be worthy just creeps me out

reminds me of the bergdahl kid who we negotiated to bring back from the taliban

when we do this- only the 1 percent will be deemed worthy and quite frankly i will scratch the donor sticker off my drivers license

[TexasMommaWithAHat]

18. It's not a matter of being worthy

Instead, it is a matter of trying to get the most success with limited resources. These are clinical decisions made with clinical criteria, and has nothing to do with "worthiness."

If you volunteer at a soup kitchen 40 hours a week, but don't take your meds regularly, you will likely not be a candidate, either.

[Ms. Toad]

20. It has NOTHING to do with being worthy.

It has to do with being willing to comply with strict behavioral guidelines - which you have to do in order to keep a transplanted organ alive - for the rest of your life. Someone who has trouble complying with school or legal restrictions is far less likely to be able to comply with what is needed in order to keep the organ from being wasted.

If there were enough donor hearts for everyone to have, the screening requirements wouldn't need to be so strict. But people die on the waiting list all the time.

So there are screening requirements imposed which are based not on worthiness, but on likelihood to be able to be a medically successful transplant recipient. Some of those may look like worthiness requirements - but they are, in reality, requirements which, over time, have been determined to be most predictive of who will be able to stick to the strict behavioral guidelines required of all organ recipients (doctor's visits, strict timing on when meds are taken, close monitoring and reporting of any changes, avoidance of drugs which are not prescribed by (or consented to) by your transplant team (since they are the ones who control rejection and know which interactions might pose risks).

[dembotoz]

33. basic behavioral yes but to attach value statements makes me nervous

longer i live the less i trust guideines

[Ms. Toad]

35. Spend some time reading the actual guidelines.

before you reject them. Because my daughter will need a liver one day, I have.

Talk with transplant recipients about what their life is like post-transplant - I've done that too.

Research all those exceptions where it looks as if money, or fame, or prominence were values which got them to the front of the line. They sure did Cheney a lot of good - he was on the transplant list longer than average for the region that did his transplant before his name popped to the top of the list.

As for "value statements," neither the OP, nor the article make value statements. You are the one who raised the question of being "worthy" - and what I am telling you is that "worth" has NOTHING to do with whether you receive a heart. Read the guidelines, and more generally.

[Yo_Mama]

17. OH, how tragic.! On ALL levels. n/t

[valerief]

24. It's okay, cop apologists. The victim was black.

[kelly1mm]

26. By 'victim' I assume you mean the elderly lady the perp shot at, right? nt

[NaturalHigh]

29. This has nothing to do with race or "cop apologists."

The cops weren't chasing him because he was speeding. He was a suspect in a home invasion and shooting. We're not talking about a teenage prank here.

[romanic]

41. Wow what a failure of a comment

.

[Corey_Baker08]

69. In A High Speed Pursuit You Really Think The Cops Even Knew He Was Black?

Or are you suggesting that if it was a white man that burglarized & then attempted to murder an 81 year old lady who was driving a stolen vehicle and being an armed suspect, if he was white the Police would have stopped the pursuit?

No Cop Apologist, Just A Realist, But I Guess In Your Mind Police Can & Have Never Done Good...

Just wait, if you haven't already, there will come a time when you need the Police, and I hope you remember when you need their help all the times you have bashed all Police...

[NaturalHigh]

31. This is precisely why the transplant board...

is supposed to operate by strict, objective guidelines. The kid was wearing a monitoring device before political pressure convinced the board to award the transplant to Stokes instead of another candidate. Someone who might have actually made the most of this second chance probably died so that the heart would go to this kid.

What a tragedy and a waste for everyone involved. Best wishes to his family.

[KamaAina]

37. I can only imagine what I'd be reading about this at Frei Republik

based on what I'm reading here at DU.

[Historic NY]

38. He was non-compliant to the end...

now he's tilted. What a waste of a good heart.

[romanic]

42. A waste of a 2nd chance indeed

This useless violent sob should have never been given the heart in the first place. He was a criminal before and was still a criminal at his death. A true waste.

And something else; to those that are crying racism at the justified outrage of this chance wasted - how many young kids, black or white or otherwise passed on when this dipshit was given the heart? Another question, if he hadn't been on a chase and continued his crime spree, how many lives would he have ruined? Better question, if he had committed another home invasion and shot and killed another black man, would you be equally outraged at another black life lost or would you waste pity on this lowlife?

I'll wait and see if anyone answers.

[still_one]

51. OK, so it didn't work out in this case. What does that mean? Should transplants only be given to

those that don't have low grades or a history of trouble with the law?

If that were the case then Cheney would never have gotten his heart transplant

[Ace Rothstein]

54. Since the number of available organs does not meet the number of people in need of them...

...then yes, you have to make difficult decisions on who receives them.

[still_one]

59. I know, I just wanted to get my scarcasm about Cheney in

[fiddodiddo]

56. Sad case

Rest in peace.

[Sunlei]

57. the car was almost split in half in the 'chase wreck', the youth had to be cut out of the wreckage.

I do NOT think police should chase runners like they do. Once they have them from the chopper, keep an eye on them from the sky.

[Corey_Baker08]

70. In This Case He Is Not Just A 'Runner' He Is An Armed Attempted Murderer Who Ran From Police...

Most Police Departments have policies for ceasing a fleeing motor vehicle. Yet in those cases it is usually for minor traffic violations or if they have a license plate number not reported stolen. This young man burglarized an 81 year old womans home, attempted to murder her, stole a car, and was an armed suspect running from Police, in no way shape or form does this warrant ceasing the chase and basically letting a man get away after attempting to murder an elderly woman.

BTW There Was No Police Helicopter Covering The Chase, & Even If There Was, The Vehicle Was Stolen Meaning He Would Have Ditched The Car & Probably Ran Into Someone Elses House Car Jacking Them, Helicopters Can Be Avoided Especially When The Subject Is On Foot...

[Sunlei]

73. the police just said it was a similar car & person. Not that he was the burglar.

The police escalate everything they do these days. Police have to change their tactics. Police are the danger to society.

[romanic]

81. "The danger to society"

Was this lowlife carjacking somebody in a mall parking lot and then using the same car to rob and shoot at an elderly woman in HER OWN HOUSE. Of course the police escalated the chase, this waste of sperm was on a crime spree and as cops, I'd hope they'd keep on the idiot's trail to catch him before he hurt - or God forbid - kill someone during his little tirade; which he almost did when he ran over someone before crashing into the pole.

JFC some people just can't drop their biases and use their brains I guess.

[LisaL]

83. Yes, there was someone carjacked, an elderely woman shot,

and a pedestrian injured during the chase.

[LisaL]

82. From what is being reported, the car was carjacked from the mall.

[NickB79]

74. Did they have him from the chopper?

I didn't see that part in the news article.

[VScott]

72. Seems like a nice kid.

He had so much potential to make something of himself.

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http://www.dailymail.co.uk/news/article-3021384/Heart-recipient-17-dies-high-speed-police-chase-crash-two-years-nearly-denied-transplant-bad-behavior.html