A 45-YEAR-OLD ON­TARIO MAN WHO NEEDS A NEW LIVER IS HEADED TO COURT TO TRY TO FORCE HEALTH AU­THOR­I­TIES TO PUT HIM ON THE TRANS­PLANT LIST DE­SPITE A RULE SAY­ING HE MUST BE SOBER SIX MONTHS.

The London Free Press - - NP - Tom Black­well

Cary Gal­lant’s al­co­holic liver dis­ease is so ad­vanced, doc­tors say the Sault Ste. Marie, Ont., man has just a 25-per­cent chance of sur­viv­ing the next six months. One thing — an or­gan trans­plant — could save his life. But it’s not an op­tion be­cause of a long-stand­ing rule stip­u­lat­ing that such pa­tients be sober six months be­fore be­ing con­sid­ered for the pro­ce­dure. So in what ap­pears to be an un­prece­dented legal tac­tic, Gal­lant plans to ask the courts next week for an in­junc­tion forc­ing pro­vin­cial au­thor­i­ties to place him onto On­tario’s trans­plant list. The 45-year-old’s lawyer, Michael Fen­rick, said he’s un­aware of any other at­tempt to have a Cana­dian made el­i­gi­ble for a trans­plant through ju­di­cial or­der. The in­junc­tion re­quest is part of a con­sti­tu­tional chal­lenge of a pol­icy Fen­rick says has no foun­da­tion in science, but much to do with the stigma around drink­ing-re­lated ill­ness. “This is re­ally his only and best hope, sadly,” the lawyer said. “In or­der to be listed for a trans­plant in the first place, you’re likely in a sit­u­a­tion where your life is in grave and im­mi­nent peril … Peo­ple in this sit­u­a­tion most of­ten can’t wait six months.” The court ap­pli­ca­tion, to be filed early next week, does not ask that Gal­lant be al­lowed to jump the queue for an or­gan, only be as­sessed un­der the same cri­te­ria as pa­tients with other types of liver dis­ease, Fen­rick said. “He doesn’t (nec­es­sar­ily) get an or­gan out of this, but at least he gets over that in­sur­mount­able hur­dle cre­ated by the pol­icy,” the lawyer said. “And maybe then his life will be saved.” Of­fi­cials with the Tril­lium Gift of Life Net­work, the pro­vin­cial agency that over­sees the trans­plant sys­tem in On­tario, were not avail­able for comment Thurs­day. On­tario and most other ju­ris­dic­tions in the West­ern world fol­low a pol­icy that re­quires pa­tients suf­fer­ing from ad­vanced, al­co­hollinked liver dis­ease to be ab­sti­nent for six months be­fore be­ing con­sid­ered for a trans­plant. The oft-stated ra­tio­nale is pa­tients would oth­er­wise be likely to start drink­ing again af­ter their op­er­a­tion, putting their new or­gan in dan­ger and po­ten­tially squan­der­ing a scarce resource. Trans­plant ad­min­is­tra­tors also worry that open­ing the sys­tem wider might de­ter peo­ple from agree­ing to do­nate or­gans. But Fen­rick said a grow­ing body of ev­i­dence sug­gests al­co­holic pa­tients are just as likely to do well af­ter a liver trans­plant as oth­ers, and that only a small per­cent­age re­vert to drink­ing. A 2013 jour­nal pa­per by six Cana­dian ex­perts called the pol­icy dis­crim­i­na­tion, not­ing even those who take up al­co­hol again con­sume small amounts that are un­likely to harm their new liver. Fen­rick ar­gues the six­month ab­sti­nence rule vi­o­lates con­sti­tu­tional equal­ity rights — which bar dis­crim­i­na­tion on the ba­sis of dis­abil­ity — and the right to life, lib­erty and se­cu­rity of the per­son. Gal­lant — who has strug­gled with drink­ing for 20 years — was ad­mit­ted to hos­pi­tal in July suf­fer­ing from jaun­dice, and even­tu­ally di­ag­nosed with al­co­holic cir­rho­sis of the liver, al­co­holic hep­ati­tis and re­lated con­di­tions. He has been sober since July 8, but doc­tors told him early last month he had a 75-per-cent chance of dy­ing within six months if he doesn’t get a new liver. His 74-year-old mother, a re­tired medical sec­re­tary who lost an­other son to bronchial pneu­mo­nia in 2013 and looks af­ter a daugh­ter with mul­ti­ple scle­ro­sis, is now also car­ing for Gal­lant at her home.

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