Bioethics Blogs

BIOETHICSTV: House of Cards Shuffles The Deck on Organ Allocation

by Craig Klugman, Ph.D.

BioethicsTV is an occasional feature where we examine bioethical issues raised in televised medical dramas.

This past weekend I was binging on House of Cards, season 4. Although this is not a medical drama, a story arch this season is relevant to this column.

If you have not watched yet, please be warned that this post is a big spoiler. Read no further if you care about such things.

One of the storylines this season is about President Underwood being shot and most of his liver removed. The doctors hope that the organ will regenerate but it does not. Doug Stamper, his chief of staff, searches for information on being a live organ donor and when he does volunteer, the doctors tell him that Underwood is too far gone for a partial organ; he needs an entire new liver. What is not discussed because no testing occurs is that Stamper is a recovering alcoholic.

Being the President does not give you much of a leg-up on the organ waiting list, according to Cards and in real life. More simply, the computer algorithm that allocates organs would have no knowledge that a patient is the President. Social worth criteria are absent from the computer system, though such considerations often are taken into account when a transplant center decides whether to put a patient onto the list in the first place.

But in the Cards universe, Underwood is very sick and is number 3 on the list. Stamper makes a visit to the Secretary of Health and Human Services who shows Stamper that the President is now number 2 on the list, because the first person received an organ.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.