No vax, no kidney: What are the bioethics behind UCHealth's decision?

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KARE11.com 07 October, 2021 - 06:06pm 2 views

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MINNEAPOLIS — Leilani Lutali was in line for a new kidney — was in line for a new kidney.

That was until she received a letter from the University of Colorado Health system, saying that she will not be receiving a kidney unless she gets vaccinated against COVID-19.

UCHealth said the policy change was driven by the significantly higher mortality rate, as well as the concern that living donors could still pass on a COVID infection after testing negative.

"This is why it is essential that both the recipient and the living donor be vaccinated and take other precautions prior to undergoing transplant surgery," it said. "Surgeries may be postponed until patients take all required precautions in order to give them the best chance at positive outcomes."

"I'm being coerced into making a decision is one I'm not comfortable making right now in order to live," Lutali told 9News.

She says she's declined the COVID vaccine due to religious reasons and she's not budging.

"Don't want this to be hinged on my freedom of choice being taken away from me, and that's what I feel is happening here," she said.

And the kidney that could have gone to her?

Is Lutali's friend Jaimee Fougner's, who also has not been vaccinated for the same religious reason.

"I said if I'm the one, and I can't give her my kidney, essentially I'm also now condemning my friend to death, because I can't get the vaccine," Fougner also told 9News.

"I found myself, I think, trying to understand where the Hippocratic Oath comes in to play here?" Lutali said. "About do no harm."

So let's talk about the oath. We asked Joel Wu, a bioethicist at the University of Minnesota, about it.

"The Hippocratic Oath has a particular place in the culture of medicine," Wu said. "Whether or not it is morally or ethically binding is less of the issue, because it's pretty narrow. The medical enterprise and the medical profession has grown a lot since then, so our conceptions of the rights and obligations that patients have and how they relate to the rights and obligations that care providers have, is very, very different. And isn't reducible anymore to the Hippocratic Oath."

Wu says the ethics of a transplant surgery really prioritizes one thing.

"We're trying to maximize the opportunity for a good outcome from what's otherwise a really risky, a really complicated and a really involved, enterprise here," Wu said. "When you get a transplant you're not done after the surgery. There's a lot of stuff you've got to do."

From staying healthy and quitting detrimental habits like smoking, to diligently keeping up with anti-rejection medication, a transplant is a commitment.

And bioethics focuses on whether that is an investment worth making because organs are rare. According to transplants.org, 114,927 Americans are on the transplant list, waiting for an organ.

"When we're talking about scarce resources, there really are two things that need to be balanced," Wu said. "The first is that there is some obligation to maximize and optimize the benefits that are available out of the resources. So you want to maximize the benefit and minimize harm. The other is that the benefits and burdens are distributed fairly."

In terms of the argument Lutali used to ask for a fair shot at a second chance?Wu was not able to specifically comment on it, but said the transplant pre-op recommendations or criteria are not meant to be punitive. 

"It's not that you're having a second chance taken away," Wu said. "It's rather that the medical enterprise has a moral and a professional obligation to maximize any chance for anybody."

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Unvaxxed Colorado woman speaks out after hospital denies life-saving transplant: 'My days are numbered'

Fox News 09 October, 2021 - 09:18am

This material may not be published, broadcast, rewritten, or redistributed. ©2021 FOX News Network, LLC. All rights reserved. Quotes displayed in real-time or delayed by at least 15 minutes. Market data provided by Factset. Powered and implemented by FactSet Digital Solutions. Legal Statement. Mutual Fund and ETF data provided by Refinitiv Lipper.

Unvaxxed kidney candidate Laylani Lutali says she’s stunned at the lack of compassion from the medical community — it’s like they’re holding her kidney hostage.

A Colorado woman who has stage 5 renal failure went on "The Ingraham Angle" Thursday to talk about being denied a kidney transplant due to her and her prospective donor's vaccination status.

"I believe that my days are numbered as I continue to deteriorate in my GFR numbers," Leilani Lutali said. GFR, or glomerular filtration rate, measures how well the kidneys are functioning in filtering out toxins and waste from the blood. A number of 60 or higher is considered normal. Stage 5 is characterized by GFR numbers below 15, where the kidneys have almost or completely stopped their functioning. 

In September, the Colorado health system, UCHealth, denied the transplant due to the fact that she had not received a vaccine, Lutali said. 

"I did reach out to the hospital to decide whether dialysis was an option. They said at this point the [vaccine] shot would not be required, but told me I was irresponsible in not getting it," she said. 

Lutali's donor, Jaimee Fougner, expressed her outrage about the hospital's decision. She previously said, "How can I sit here and allow them to murder my friend when I’ve got a perfectly good kidney and can save her life?" 

The two met in Bible study less than a year ago. 

"I want to start crying," host Laura Ingraham said about seeing the two friends together. "That's the most selfless thing, that's incredible," Ingraham said about Fougner's willingness to donate her kidney. 

Fougner said she was "stunned at the lack of compassion and consideration" in allowing Lutali to be the driver in her own care. "They're holding my kidney hostage and she's going to die because they won't give it to her," she said. 

Ingraham asked if there was any justification or science behind the hospital's decision.

Leilani said she proposed a number of remedies, including signing a medical waiver regarding not taking the vaccine. 

Ingraham concluded that this sounded like "a classic case of discrimination."

"I don't know if people are smoking too much pot in Colorado, or what's going on," Ingraham said. 

The health system released a statement that said, "For transplant patients who contract COVID-19, the mortality rate ranges from about 20% to more than 30%. This shows the extreme risk that COVID-19 poses to transplant recipients after their surgeries." 

Hannah Grossman is an Associate Editor at Fox News. Follow her on Twitter at @GrossmanHannah

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This material may not be published, broadcast, rewritten, or redistributed. ©2021 FOX News Network, LLC. All rights reserved. Quotes displayed in real-time or delayed by at least 15 minutes. Market data provided by Factset. Powered and implemented by FactSet Digital Solutions. Legal Statement. Mutual Fund and ETF data provided by Refinitiv Lipper.

A Colorado Woman Who Refused COVID-19 Vaccine Because of Her Faith Is Denied Kidney Transplant

Inside Edition 09 October, 2021 - 09:18am

Leilani Lutali, a born-again Christian, is aware of the risks involved if she doesn’t get the transplant but said she could not agree to be vaccinated because of the role that stem cells have played in the development of vaccines, according to the Associated Press.

“As a Christian, I can’t support anything that has to do with the abortion of babies, and the sanctity of life for me is precious,” Lutali said.

Despite Lutali’s views, many major religious denominations have no objections to the COVID-19 vaccines. The Vatican’s doctrine said it was “morally acceptable,” for Catholics to receive the COVID-19 vaccine that are based on research that it uses cells derived from aborted fetuses, according to the AP. In the spring, Pope Francis became fully vaccinated with the Pfizer shot and told Italian broadcaster Canale 5 "anti-vaxxers" are living in inexplicable "suicidal denial," according to a previously reported CBS News story.

However, the debate to vaccinate or not to vaccinate — even when a person’s life may be in jeopardy — has sparked varied heated discussions about whether cell lines derived from fetal tissue have played a role, directly or indirectly, in the research and development of various vaccines and medicines, the AP reported.

UCHealth Hospital spokesperson, Dan Weaver said UCHealth requires transplant recipients to be vaccinated before a life-saving procedure because recipients are at greater risk of contracting COVID-19 as well as being hospitalized and dying from the virus, Dayton247Now reported.

The spokesman added that unvaccinated donors could also pass COVID-19 to the recipient even if they initially test negative for the disease, the AP reported.

“Studies have found transplant patients who contract COVID-19 may have a mortality rate of 20% or higher,” Weaver said in the AP report.

Many transplant programs insist that patients get vaccinated for COVID-19 because of their weakened immune systems, according to the American Hospital Association, (AHA) which represents nearly 5,000 hospitals, health care systems, and networks in the United States, the AP report said.

The AHA said it did not have data to share on the issue, nor is it clear how common this type of policy is, the AP reported. 

However, transplant centers in Washington, Vermont, Massachusetts, and Alabama have policies requiring that recipients be vaccinated, according to the AP. The Mayo Clinic and Sentara Healthcare, two of the nation’s largest health care systems, said they “recommend or strongly encourage” vaccinations for transplants, the AP reported. Most recently, the Cleveland Clinic said in a statement that it recently decided to require COVID-19 vaccinations for transplant and donor recipients, the AP noted. 

The University of Alabama Birmingham’s School of Medicine transplant program; however, recommends donors receive a vaccine but does not require for the donation process, according to the AP.

The AP reported that Leilani Lutali hopes to find another hospital that would allow the transplant without a vaccine and is searching in Texas and Florida. Lutali, who believes in the afterlife, said she does not fear dying, and feels hopeful, according to the AP.

“I have hope that something will come along that is something I can live with in terms of my choices,” she said in the AP report.

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Colorado woman denied kidney transplant after refusing COVID-19 vaccine for religious reasons

FOX 13 Tampa Bay 08 October, 2021 - 01:23pm

When a Colorado woman found out her hospital wouldn’t approve her kidney transplant surgery until she got the COVID-19 vaccine, she was left with a difficult decision pitting her health needs against her religious beliefs.

Leilani Lutali, a born-again Christian, went with her faith.

Even though she has stage 5 kidney disease that puts her at risk of dying without a new kidney, Lutali, 56, said she could not agree to be vaccinated because of the role that fetal cell lines have played in the development of vaccines. Several types of cell lines created decades ago using fetal tissue are widely used in medical manufacturing but the cells in them today are clones of the early cells, not the original tissue.

"As a Christian, I can't support anything that has to do with abortion of babies, and the sanctity of life for me is precious," she said.

RELATED: Multiple hospitals denying organ transplants to unvaccinated patients

UCHealth requires transplant recipients to be vaccinated because recipients are at significant risk of contracting COVID-19 as well as being hospitalized and dying from the virus, spokesman Dan Weaver said. Unvaccinated donors could also pass COVID-19 to the recipient even if they initially test negative for the disease, he said.

"Studies have found transplant patients who contract COVID-19 may have a mortality rate of 20% or higher," he said.

It’s not clear how common this type of policy is.

The American Hospital Association, which represents nearly 5,000 hospitals, health care systems and networks in the United States, said it did not have data to share on the issue. But it said many transplant programs insist that patients get vaccinated for COVID-19 because of the weakened state of their immune system.

RELATED: COVID-19 vaccine hesitancy may be waning over time, survey suggests

While any type of surgery may stress a patient’s immune system and leave them vulnerable to contracting COVID-19 later, organ transplants recipients are even more at risk because they have to take a powerful regime of drugs to suppress their immune system to keep their body from rejecting the new organ, which is seen by the body as a foreign object, Nancy Foster, AHA’s vice president for quality and patient safety policy said in a statement.

"Further, if patients were to wait to get their vaccine until after the surgery, it is unlikely that their immune system could mount the desired antibody reaction given that they are taking anti-rejection medications," she said.

Transplant centers in Washington, Vermont, Massachusetts and Alabama have policies requiring that recipients be vaccinated, according to news reports.

Cleveland Clinic recently decided to require COVID-19 vaccinations for both transplant recipients and living donors, the organization said in a statement.

RELATED: Maryland killing spree suspect told people his brother was ‘killing people with COVID vaccines’: police

Some health care systems recommend or strongly encourage vaccination for transplants, including the Mayo Clinic and Sentara Healthcare, two of the nation's largest. The University of Alabama Birmingham’s School of Medicine transplant program only recommends that living donors receive a vaccine, but it does not require it for the donation process.

The best time to get a COVID-19 vaccine is before an organ transplant. If time allows, patients should get their second dose of the available vaccines at least a couple of weeks prior to transplant "so that your body has a good immune response to the vaccine," said Dr. Deepali Kumar, the American Society of Transplantation's president-elect and an infectious disease physician.

Many major religious denominations have no objections to the COVID-19 vaccines. But the rollout has prompted heated debates because of the longtime role that cell lines derived from fetal tissue have played a role, directly or indirectly, in the research and development of various vaccines and medicines.

Roman Catholic leaders in New Orleans and St. Louis went so far as to call Johnson & Johnson’s COVID-19 shot "morally compromised." J&J has stressed that there is no fetal tissue in its vaccine.

RELATED: Pope expresses 'shame' at scale of child sex abuse by clergy in France

Moreover, the Vatican’s doctrine office has said it is "morally acceptable" for Catholics to receive COVID-19 vaccines that are based on research that used cells derived from aborted fetuses. Pope Francis himself has said it would be "suicide" not to get the shot, and he has been fully vaccinated with the Pfizer formula.

Ethical considerations should take both individual and societal perspectives into account, Dr. Kumar said.

"It’s really what’s best for the patient at this time and from a societal perspective as well," she said. "The more patients that get vaccinated, you know, we have better outcomes."

To Lutali, a recruiter for tech companies, it seems like her hospital was so insistent on saving her from COVID-19 that is willing to let her possibly die by blocking her transplant surgery.

RELATED: More than 120K US kids had primary caregivers die during pandemic

Lutali, who does not belong to a denomination, said she does not live in fear of dying because of her belief in the afterlife. She is searching for another hospital, possibly in Texas or Florida, where she could get a transplant without being vaccinated.

"I have hope that something will come along that is something I can live with in terms of my choices," she said.

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