Soliciting organ donations undermines fairness of waiting list, surgeon writes

Excerpts from the Globe's blog on the Boston-area medical community.

Soliciting organ donations, whether on billboards or on the Internet, raises ethical questions and threatens the fairness of how organs are allocated, Dr. Douglas W. Hanto wrote in last week's New England Journal of Medicine.

Organs from deceased donors go to the people at the top of the waiting list maintained by the United Network for Organ Sharing, which is regulated by the federal government. The only exception is made for family members of deceased donors.

But when it comes to living donors who may come forward to give a kidney or part of a liver, there are no policies regulating directed donations, writes Hanto, chief of transplantation at Beth Israel Deaconess Medical Center and professor of surgery at Harvard Medical School.

McLean Hospital in Belmont will lead the first large-scale study of a treatment for people addicted to pain medications such as Vicodin and OxyContin, the National Institute on Drug Abuse said last week.

Researchers will recruit 648 participants at 11 sites, hoping to enroll both people who have taken prescription medications for pain relief but later became addicted, as well as people who take the drugs illicitly for nonmedical reasons. People interested in participating can call 617-855-2588.

"The major contribution of this study is that it's focusing on this specific problem of prescription opiate dependence," said Dr. Roger Weiss, clinical director of McLean Hospital's Alcohol and Drug Abuse Treatment Center and lead investigator for the study. "Most studies that have looked at opiate dependence have been done on heroin addicts with a sprinkling of people with prescription opiate dependence."

Drug testing of adolescents at home or in school is unreliable and lacks scientific proof of effectiveness, the American Academy of Pediatrics said in its journal Pediatrics last week. Simple conversations with a school counselor are more effective and cost far less, according to the study.

It's very hard to perform the test properly and tests are best used to ensure people are succesfully battling their drug habit, said Dr. John R. Knight, associate professor of pediatrics at Harvard Medical School and director of the Center for Adolescent Substance Abuse Research at Children's Hospital Boston. He is the lead author of the article.

LIZ COONEY