MORE ON WHO GETS THE BEST KIDNEY

Even among The Kidney Group, rationing of kidneys, potentially, in favor of younger patients is a hot button topic. One colleague called me this morning to say "Physiologic age is more important than chronological age", which I don't argue. "You should have said that", he insisted. But it is more than that. Another doctor in the group wants more studies that look at are we wasting kidneys on older people? How long do they last in a 70 year old vs a 30 year old? To which I clicked off the painful list of young patients in recent memory who lost a parent's kidney through neglect, including one who was a former employee's son. Can you think of a senior patient that did that, I asked? He could not.And of course, my mother asks "What is old?" (Correct answer-Not you, Mom).
It is a huge question with ethical and political ramifications that could be staggering. Is it the start of rationing of healthcare? Is dialysis next? Worrying what will be the shady side of the cut-off, or wondering what else will be rationed? Will I have the resources, then, to pay for health care denied me by age? Will you? Or your parents? I don't know. I only know, as I said last night, it's got me concerned.