Steve Jobs, His Transplant, and Whose Business Is It Anyway?
Whether you follow health news or business news, you couldn't help but notice the hub-bub about Steve Jobs, the founder and CEO of Apple Computer, and his liver transplant. While most of us will never need such a drastic and difficult treatment, Jobs' approach to getting the healthcare he needed raises both process and ethical questions.
Some Background:
Steve Jobs, age 54, is an icon of business, the "god" of Apple computer, with a creative and inventive mind. Over the years he has earned billions of dollars for himself, his company and his stockholders.
Steve Jobs is/was also a very sick man. He has battled pancreatic tumors for a number of years, and ultimately knew he could no longer survive without a liver transplant. So, he got one.
What's unique, and is causing controversy, is that Jobs lives in California where the waiting list for a liver would have made it impossible for him to get one. In California he would have died. So instead he kept an eye on areas of the United States where the waiting lists are far shorter. When a liver became available in Tennessee, Jobs hopped his private jet and claimed it.
Some argue that wasn't fair. That someone in Tennessee didn't get a liver (and possibly died) because Jobs jumped the line. In the United States, you can't buy an organ. There is a complicated system that moves people closer to, or farther from, the front of the line depending on the depth of their illness and their geography. Because Jobs had the money and the private plane, he could affect his geography.
There is further controversy because investors in Apple Computers feel as if they should have been told about Jobs' degree of illness. Since it affects their income, they contend they had a right to know, and they are upset because they weren't told about his need and pursuit of a transplant.
The Questions:
Health: Was it fair for Jobs to jump the line by traveling to Tennessee to get his new liver?
Business: Did Jobs owe his stockholders information about his health so they could make business decisions?
My Opinions:
Health: Jobs' ability to jump the line points out the inequities in a system that has mostly been considered to be highly ethical and fair. On any given day in the United States there are 100,000 people awaiting a transplant, and 19 of them die. In a general sense, I understand why some think it's not fair, especially the family of someone who may have died because Jobs got the liver they might have gotten. However -- if you had the need and the means, wouldn't you do whatever you could to get the treatment you needed?
Business: No matter whether Jobs was president of a large corporation or a greeter at Wal-mart, I believe he owes information about his health to no one else. It's HIS health. It's HIS private business. No matter how his investors feel about it, including Warren Buffett who believes Jobs' condition should have been disclosed, I say - no, Jobs owed information to no one. Besides, he's been sick for a long time -- that was nothing new. Granted, we would all like a crystal ball when we buy stock, but he could have been hit by a truck or died in a plane crash and it would not have been predicted.
What do you think?
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I’m basically with you on the ethics of the transplant itself, but I disagree with you on whether he should have been required to disclose some (not all) of his health details for a few reasons.
1.) There’s been a long string of “Jobs is fine!” messages from Apple ever since Jobs’s surgery for his adenocarcinoma. Then he goes on medical leave. Then all of a sudden he gets a liver transplant. That is one hell of a bait and switch.
2.) While I don’t think anyone needs the specifics of his health records, if people knew he were sick enough to be on the transplant list that’s something that raises the question of “who’s running the company on a day-to-day basis?” I think that’s a legitimate business question — has Jobs been as involved as the rumors say he’s been from medical leave? Is Tim Cook really in charge? Is there a real chance Jobs will stay around?
3.) The “hit by a bus” and “terminally ill” scenarios are just not the same. Yes, there’s a chance anyone, anywhere could have a freak accident or a catastrophic heart attack or aneurysm that kills or incapacitates them. But when you have time to plan that the company is taking advantage of, all things being equal the stockholders want to take advantage of it too, to gauge whether they think the new management will be competent. (Which is one of those places where the company’s interest and their stockholders’ interests are aligned; a mass selloff, as could happen in the “hit by a bus” scenario, doesn’t help anyone.)
Steve Jobs did not jump the line. He took advantage of something that every potential transplant patient has the right to do, he utilized the right to be listed for a transplant at multiple transplant centers.
I hope his story encourages other people to do the same. For example, a potential kidney recipient in NY will probably wait for 7 years for a cadaveric organ, while the same person in Ohio will probably wait for 2-3 years. Worth hopping in the car for and driving through the night? Absolutely!
If I needed an organ, you can bet I’d be listed at more than one transplant center. People do it every day.
I am sure that Mr. Job’s company has made many contributions to organizations that help countless less-fortunate folks with serious needs. True, no one should be able to “buy” an organ, but at some point, his generosity should be recognized and appreciated. How many people were not able to afford insurance if it were not for his health plan thru Apple. He is a saint and I wish him well.
This post is an excellent example of what is wrong with self-appointed internet “experts” who claim authority without putting any thought into what they are publishing or doing minimal verification. This site is more egregious than gossip sites or random commenters because it claims the high ground. People trust you. Maybe you know something about patients’ rights, but you know very little about responsibility and accuracy.
Your statement that “Steve Jobs jumped the line” has no basis in fact. You write as if you confirmed this accusation, and then extend the offense by suggesting that somebody died so he could live. Who exactly should have gotten that liver? Do you know that an eligible person with compatible tissue was pushed aside — and then died? The fact that “some” suggested that scenario does not excuse you from repeating it.
People travel from California to Tennessee, even without access to a private jet. There are commercial flights every day, not to mention an excellent interstate highway system and AMTRAK. Ordinary people cross state lines with amazing frequency for medical treatment. This was not, as you hyperbolically assert, “unique.” I’m sure you really know that people from everywhere receive treatment at facilities such as Mayo Clinic, Johns Hopkins, Sloan-Kettering and Duke University Hospital. And Betty Ford, too. “Unique” does not mean “interesting.” It means “one of a kind.”
And by hopping on his private jet and “claiming” a liver, do you actually mean he moved to Tennessee months ago and waited for a transplant?
When you say out of 100,000 people waiting for a transplant, 19 die, do you mean to say that only critically ill people with a life expectancy of less than a year and no treatment options are waiting for a transplant? I thought so.
By the way, I recently met a guy who has had a two liver transplants in nine years, and is now awaiting a heart-liver transplant. His underlying disease? Cirrhosis. He’s not rich. He’s been on disability for years. One might argue that he caused his own disease, and maybe he got organs that someone else deserved. The thrust of your blog is that transplants only go to wealthy, privileged people, but it’s a fact that convicted felons and Medicaid recipients get them as well.
Finally, I am amused at the detailed discussion of Steve Jobs’ health, leading finally to the opinion that Steve Jobs’ health is nobody’s business but his own.
Except those trying to drive traffic to their sites I guess. This is a nice example of cognitive dissonance.
If anyone is stepping on others for personal gain, it is the pontificators taking shortcuts to leech some spotlight.
The commenter above didn’t bother to check facts, either.
According to the United Network for Organ Sharing http://www.unos.org/news/newsDetail.asp?id=1265
there are 15,000 people on the list for liver transplants. The 100,000 figure is for all organs, but that wasn’t made clear in Trisha’s piece.
Here’s a chart showing people waiting, actual number of transplants and number of deaths.
http://www.ustransplant.org/csr/current/FastFacts/datatour.aspx?s=1
The article on Bloomberg that Trisha linked to makes it clear that it is not unusual for patients to get on the waiting list at several different facilities. Some have a few dozen on their waiting list while others have hundreds.
As a family member of someone with a serious illness, I do not want my choice of hospital taken away. Are you arguing that people should be only allowed to use a hospital close to where they live or work? We recently switched hospitals and doctors due to concerns about the quality of care.
Yes, the phrasing “In California he would have died” is inflammatory. It might have been more prudent to say he had less of a chance of getting a life-saving transplant.
Trisha is wrong on both counts. Morally wrong on the liver and ethically wrong on the lying about it.
Jobs is rich, so he could put himself on any number of ‘lists’ for a new liver; the one in Tennessee just happened to be the closest match in the right time frame. Someone who does not have his money can’t do that; they have to take what’s available that they can afford or their insurance will pay for.
And when Apple told everyone that Jobs was fine, they either knew he wasn’t (in which case they lied) or Jobs lied to them. When you are the head of any major organization, you have a responsibility to be both honest AND above board. If you have a potentially fatal health problem, you need to advise your shareholders. If that means that you will share information that, for the average person would be confidential, so be it. That’s the price you pay for the position.
And don’t any dare try to say that Jobs isn’t essential to Apple. His fingerprints are everywhere in that company and at this time, there is no successor.