Life and Death in the War Zone

Student Handout

You Be the Judge

You are a member of the Transplant Review Board at City General Hospital. Four patients, all with the same lung size and blood type, are on a transplant waiting list. Your job is to decide who should receive the lung transplant when the next suitable organ becomes available.


  1. Read each case study.

  2. Discuss with team members what kinds of criteria would be important in making this decision and create a set of guidelines based on your discussion. Review each case using these guidelines.

  3. Who would you choose for the transplant? Defend your reasoning.

  4. Is there any additional information you would have liked to know in order to make your decision? If so, create a list of what else you would have wanted to know. State reasons why that information might have helped guide your choice.

Ms. L.
A 45-year-old single parent with five children. She is a chiropractor, but because of her illness she can only work a few hours each week. She enjoys watching TV and reading mystery novels. Ms. L. has emphysema. Her doctors believe that her disease is the result of 20 years of smoking three packs of cigarettes a day. Ms. L's. life is expected to radically improve from a successful transplant. She does not have health insurance. To pay for her operation, she would have to ask for donations.

Mr. Z.
A 54-year-old man. He has come to the United States from Europe for a lung transplant. He owns a successful international trading company. He misses his wife and two children who stayed behind. He spends a lot of time at his job, but enjoys fishing and traveling. While he is expected to benefit greatly from the transplant, his disease makes it likely that he will need another transplant in 10 years. If he receives the lungs, he will not only pay for the operation himself, but will also make a large donation to the hospital.

Mrs. P.
An 88-year-old widow. She was happily married for 32 years. Recently, her husband died, leaving Mrs. P. alone to care for a big house in the country. She enjoys gardening and flower arranging. Mrs. P. also volunteers four hours each week at the local AIDS clinic, caring for infants with HIV. Without a transplant, Mrs. P. will have to be hooked up to an oxygen mask and have limited mobility. A successful transplant would enable her to expand what she currently does throughout the day. Medicaid will pay her medical bills.

Mr. N.
A 41-year-old meteorologist. He has been divorced five times and has no children. Until his lung disease restricted his activity, his hobbies were bungee jumping and mountain climbing. Since he's been sick, Mr. N. has become depressed and at times even feels suicidal. His condition affects other organs, so while a transplant may not highly benefit his overall condition it would likely somewhat improve his quality of life for a few years. Mr. N's insurance company will pay if he has a lung transplant.