Has the War on Drugs Gone Too Far This Time?

There lies an issue with the automatic rejection of some patients because they use "illicit substances." How far does our advocacy for our patients go?

You may never have heard of Timothy Garon, but he’s fighting a fight that may affect many of us down the road and his name is becoming more well-known in the medical community.

Timothy Garon is a 56-year-old man in Washington State, who is dying from hepatitis C. As he became ill, Mr. Garon began smoking legally prescribed medicinal pot for his hepatitis symptoms — the nausea, poor appetite and abdominal cramping. Now, because of the marijuana, he is being denied a chance at a liver transplant.

When it became apparent that Mr. Garon was deteriorating to the point that he would need a transplant, two institutions refused to even put him on the transplant list. One said that in order for Mr. Garon to be considered as a transplant candidate, he would have to abstain from smoking for 6 months; the other said that he would have to undergo a 60-day drug treatment program.

What’s wrong with this picture? Mr. Garon — and others like him – is smoking pot to quell the discomfort caused by what is making him ill. If what is making him ill is removed and replaced with a healthy organ, the need for the marijuana will be removed and he should no longer need it. Since marijuana is one of the least addicting substances, the chances of addiction, making post-operative use a possibility, are smaller than if he liked to have a tobacco cigarette. As is said in an article that appeared in the Washington Post on April 26, Medical marijuana patients face transplant hurdles, there lies an issue with the automatic rejection of some patients because they use “illicit substances” and even medicinal marijuana is considered to be an illicit substance.

Some critics of Mr. Garon’s appeal for the liver have pointed out that he may have brought this illness on himself with his lifestyle, but I believe that this argument is just clouding the issue: if you are using legally prescribed, medicinal marijuana, should you be denied a life-saving organ transplant? This question isn’t just about Mr. Garon, it’s about you and me and the people we love; people who may never have touched an illicit substance ever. If Mr. Garon doesn’t fight for his right to be placed on the list, maybe someone we love may have to go through that later on.

And in our professional lives as nurses, how far does our advocacy for our patients go? I know that there are some nurses that do agree with the decision not to allow Mr. Garon on to the transplant list, but there are many who are against the decision, as well. How do we reconcile caring for a patient who we believe is being unfairly treated or, conversely, is demanding something that we feel he shouldn’t have?

When we study nursing and over the years, we’re taught that we are the patients’ advocate. We speak and act for the patients when they can’t. But what if it’s something like this? What is our role in advocating for the patients then?

What do you think, not only about this particular patient, but about the whole issue?