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The University of Illinois agreed to pay $2.3 million to the federal government because the university hospital in Chicago (UIH) violated rules about who gets a transplanted liver. The University of Chicago (UIC) and Northwestern also had to settle government charges by paying lesser amounts.
According to the former head of UIH’s transplant program, Dr. Ray Pollack, the three medical centers were involved in competitive scams in order to get available livers, and the money that comes with transplant operations, for their own institutions, regardless of whether the patients who got the livers were next in line. This behavior violated the agreement that had been worked out nationally by the United Network for Organ Sharing, an agreement that is based on the principles of justice, equity and utility.
UIH’s unethical practices were first challenged by Dr. Pollack, who is a transplant surgeon, in the mid-1990s. When Pollack brought his concerns to top UIC officials, such as medical dean Gerald Moss, he was asked, “What’s wrong with doing things the Chicago way?” - that is, cheating so that UIH gets as many livers as possible even if they go to patients who are not yet sick enough to qualify, so that sicker patients wait. In 1998 Pollack was forced out of his position as head of UIH’s Transplant Program, which greatly upset the resident doctors, nurses and others involved in the program.
Pollack tried to resolve the problem through the United Network for Organ Sharing, a private voluntary group, without satisfaction, and eventually went to the federal government, which decided to investigate. Federal prosecutors made the hospitals involved pay fines and agree to play by the rules in the future. UIC paid by far the most because so many of its transplants were paid for by the government - at about $250,000 each for a liver transplant - and because the government had the most evidence on UIC. Probably the two private medical centers were just as much at fault.
On the day that UIC’s huge penalty came out in public, Dr. Pollack spoke to a large audience at the UIC medical school, in a talk sponsored by the local chapter of Physicians for Social Responsibility. It was an emotional and victorious moment for those who have been fighting for fairness and honesty in organ transplantation. Dr. Pollack made a point of saying that the policies of UIC had made life difficult not only for himself and other doctors, but also for nurses, technicians and support workers. Dr. Pollack, a native of South Africa, compared the situation to that of apartheid, under which people were required to work under a system based on greed and fraud.
As someone who has been involved in UIC for twenty years, and a graduate of its medical school, I’ve always been struck by how often this supposedly public institution is unwilling or unable to decide between right and wrong - and how often it has chosen wrong. I first noticed this as a medical student in 1987, when the medical center began to financially discriminate and exclude uninsured patients. A couple years later, a poorly planned merger caused the medical dean to lose his job. A few years ago, UIC’s chancellor had to resign over improper human research practices. Whether someone’s head will roll over the liver transplant scandal remains to be seen. But one positive step, which many people are demanding, is that Dr. Pollack gets his job back.
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