63-year-old Norman Smith, who was diagnosed with inoperable liver cancer in 2009, was placed on the transplant list at Cedars-Sinai Medical Center last year as his only hope of survival. But in February, he was removed from the list. The reason? He was taking the medication his oncologist has prescribed for him: medical marijuana.
As medical marijuana advocacy group Americans for Safe Access (ASA) reports, Smith's oncologist, Dr. Steven Miles, had prescribed his patient marijuana to deal with the side affects of chemotherapy and the pain from a back surgery.
And yet, doctors took Smith off of the list because he was using marijuana and did not show up for a drug test. To go back to the bottom of the list, Smith must abstain from marijuana use for six months, undergo random drug tests and receive counseling, the Los Angeles Times reports.
Dr. Steven D. Colquhoun, the director of Cedars-Sinai's Liver Transplant Program, sent a letter to Smith in May saying that the liver transplant center "must consider issues of substance abuse seriously since it does often play a role in the evolution of diseases that may require transplantation, and may adversely impact a new organ after a transplant."
Cedars-Sinai spokeswoman Sally Stewart told the Huffington Post that the hospital's policy regarding transplant candidates and marijuana use is because of a mold called aspergillus that is found in marijuana. She explained, "Aspergillus does nothing to most people but in a liver transplant patient, whose immune system is so weakened, it can cause a fatal lung infection."
However, Smith's oncologist, psychologist, medical marijuana advocates and other supporters are urging the hospital to approve Smith for a transplant. In a letter to the hospital, the ASA wrote "Denying necessary transplants to medical marijuana patients is the worst kind of discrimination. Cedars-Sinai would not be breaking any laws, federal or otherwise, by granting Norman Smith a liver transplant, and it's certainly the ethical thing to do."
Smith, who lives in Playa del Rey, is not the first medical marijuana patient to be denied a transplant, and several such cases in the past have resulted in the patient dying without the transplant he or she needs. His case touches on an unresolved bioethical debate about whether or not substance users or addicts, who likely contributed to their liver's degradation, should qualify for an organ transplant or not. How many months or years should they be clean before qualifying? Do the substance rules apply if it's a prescribed substance, such as medical marijuana?
Watch the story of a Tim Garon, who was also denied a liver transplant because of medical marijuana use, below.
Vivian Tellis, the director of the transplant program at Albert Einstein College of Medicine in New York, told ABC that someone who has used drugs or alcohol is of concern "because if you're high, you don't take your [post-transplant regimen of] pills." Maxwell J. Mehlman, director of the Law-Medicine Center at Case Western Reserve University, said that transplant centers try to be very careful because their funding depends on success rates. He told ABC that their screening process "has actually been a source of bioethical controversy because it allows them to reject homeless people and people who live alone."
The United Network of Organ Sharing, which oversees organ transplants for the US, has no standard on the use of drugs or marijuana and leaves it up to their individual transplant centers to set their own policies.
In response to losing his place on the transplant list, Smith told the LA Times, "It's frustrating. I have inoperable cancer. If I don't get a transplant, the candle's lit and it's a short fuse."