When a man is so bad he doesn't deserve a pig's heart

(Gabriel Moreno) - In words of The Washington Post writers, David Bennett became 'a medical pioneer' after the heart of a genetically modified pig was used to replace his failing heart. But the significance of this medical breakthrough in which he had been involved was eclipsed by the fact he 'had been convicted in 1988' after stabbing a man seven times.

Attention grabbing as Johnson and Wan's article is, the so called 'ethics of a second chance' angle it deploys belongs within a category of public discourse that has taxed the ability of societies to deal with the organ shortage crisis all over the world.

For several decades, medical and social scientists have known that news media are one of the most effective forms of public education interventions to reduce the shortage of organs for patients who need a transplant for a shot at carrying on with their lives. 

As put by Rafael Matesanz, architect of Spain's renowned national system of transplantation (ONT), news coverage is frequently designed to 'promote scandal or sensationalism'; it may stem from premises that 'ask pertinent questions but often promote scandal or sensationalism'.

Such coverage has been associated to important declines in rates of organ donation and family consent across national contexts. Misleading media reports add on top of the role of fictional misinformation in countering the benefits of expensive education campaigns that aim to improve organ donation and transplantation outcomes.

From scientific breakthrough to a system that benefits the undeserving

The successful transplantation of a pig's heart into David Bennett should have been an opportunity for sustained news media reflection on the pertinent questions that stem indeed from such a historic medical development. 

Indeed, when the University of Maryland Medical Center (UMMC) announced the breakthrough on 10 January, the substantial multimedia resources that it used to communicate the achievement were quickly picked up by major news organisations that correctly reflected on its importance. 

But the first successful xenotransplantation in history is a powerful example of how a narrative that promotes a strongly documented and informed coverage of OD/OT themes can be reshaped by extraneous elements of information that enter the discursive flow at a later stage.

The contamination in this case came from the news frame of ‘undeserving or ungrateful recipients’. This frame is common in entertainment television and includes ‘criminals, people who create their own health problems, or those who are not mindful of the precious gift that has been given to them’ (Morgan et al 2007: 147). 

The Washington Post's article kickstarted the undeserving frame by focusing on how surprised the sister of a man stabbed in 1988 by the pig heart recipient was when she first found that her brother’s killer had benefited from this scientific breakthrough. 

After quoting the woman’s wish that the ‘new heart… had gone to a deserving patient’, the reporters explain 106,000 Americans are on the waiting list for an organ transplant, that 17 people die everyday waiting for a suitable organ, and that 'it can seem unconscionable to some families that those convicted of violent crimes would be given a lifesaving procedure so many desperately need.’ 

Only after this, the clinical perspective is discussed in a paragraph that opens with: ‘But most doctors don’t share that view.’, as if the system that regulates the allocation of organs were a matter of opinion.

Adding fuel to public distrust

There are serious questions the news media could be raising about what health systems all over the world could be doing to save more lives. From the point of view of how organ transplantation and donation is communicated, organ shortages have been a discrete public health crisis that relies (in mature democracies) on expert systems of allocation. 

Such systems, are under the oversight of medical and clinical stakeholders that determines the distribution of scarce organs on the basis of medical priorities. 

Authorities such as NHS Blood and Transplant (NHSBT) endeavour to explain the system of organ allocation and what it is like to be on the waiting list. However, there is reason to think that news media's need for traffic and clicks, could be turning into an active contributor to the crisis of on-line mis- and disinformation that has been fuelling public distrust in the systems of expertise on which people on the organ waiting list rely.