Monday, December 9, 2013

Jobbing livers

The ethics of the allocation of organs for transplants is hard and it should be--- any proposed set of criteria will leave many people to die, given the severity of their illnesses and the shortage of organs, and there are no distribution schemes to which claims of injustice could not be raised.Given the stakes it is only natural that people with clout and cash game the system by getting onto multiple regional transplant waitlists, upping their chances. That's what Steve Jobs did, when he was seeking his liver transplant, which he ultimately got in 2009, in Memphis, Tennessee, though he lived in California. But what he also seems to have done is to have the transplant surgeon paid off.
When Jobs landed on the wait list in Memphis, his team began looking for a house for him. Transplants involve major surgery, and hospitals require out-of-town patients to secure nearby housing for the weeks of recuperation that follow. Jobs found a two-story 5,800-square-foot Italianate home near Overton Park.
The State of Tennessee owned the home. It had paid $1.3 million in 2005 for the property at 36 Morningside Place, which briefly served as the chancellor's home for the University of Tennessee Health Science Center. But now, at the height of the biggest economic recession in 70 years, the state sold the home for $850,000.
State records show Riley, Jobs' lawyer, signed a purchase agreement on March 23, 2009, as it became evident Jobs would be in Memphis for a while. Days later, he made it official, filing a deed with the Register's Office.
Secrecy surrounded the deal. Riley acquired the home in the name of a shell company, LCHG LLC, which had been recently set up by attorneys at the Burch Porter Johnson law firm in Memphis. Two years later, ownership of the home was transferred to Eason, the surgeon, for the same amount Jobs had paid — $850,000.
In a hearing in June 2012 before the Shelby County Commission, Eason faced questioning about that transaction. He was there asking for the commissioners' support during a policy dispute with UNOS, but the questioning veered into how he wound up with Jobs' home.
"It's a fair question," Eason said, assuring commissioners there was "absolutely not" any deal cut to secure a liver for Jobs.
"I took care of him and visited him in that home. When I learned that it was going to be going on the market, I asked … if I could purchase it," Eason told commissioners.
Yet Eason didn't tell commissioners all he knew.
Eason was going through a divorce and moved into the house two years before buying it. And while he was there, from early summer 2009 until he acquired the deed in May 2011, the utilities and property taxes were paid by Riley, Jobs' San Francisco lawyer. Records show Riley, who's worked as Apple's outside counsel, wrote personal checks in 2010 and 2011 totaling $23,585 to cover the property taxes. Riley also used his MasterCard to pay Memphis Light, Gas & Water $8,770 for utilities at the home through 14 payments between May 2010 and May 2011 — again as Dr. Eason lived there before buying the house. Eason put the utilities in his name after he purchased the home on May 5, 2011, records show. Eason said he lived in the home only part-time during the first of those two years as he tried to reconcile with his wife . "And then, in 2010, sometime in spring of 2010, I moved in there and stayed there until I purchased the house. And live there now," he said.
In the scheme of things, this is not a lot of money to Steve Jobs or Apple, and from the point of view of Riley and his Apple masters, the transaction might seem to be as trivial as tipping helpful waitstaff. But this 'trivial' amount of money, or its anticipation, might have incentivized Eason to push Jobs up to the top of the transplant list. 

The whole story in the Memphis Commercial Appeal goes well beyond the Jobs incident in explaining how today's organ allocation system works, and doesn't. It's well worth reading in its entirety.

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