13 Rich. J. L. & Pub. Int. 337 (2009-2010)
What Scribner Wrought: How the Invention of Modern Dialysis Shaped Health Law and Policy; Sanford, Sallie Thieme

handle is hein.journals/richlapin13 and id is 355 raw text is: WHAT SCRIBNER WROUGHT: HOW THE INVENTION OF
MODERN DIALYSIS SHAPED HEALTH LAW AND POLICY
Sallie Thieme Sanford-
I. INTRODUCTION
In March 1960, Clyde Shields, a machinist dying from incurable
kidney disease, was connected to an artificial kidney by means of a U-
shaped Teflon tube that came to be known as the Scribner shunt.1 By
facilitating long-term dialysis, Dr. Belding Scriber's invention changed
chronic kidney failure from a fatal illness to a treatable condition.2 A
half-century after this milestone, there are now more than 1.6 million
people throughout the world on maintenance dialysis.3
This medical advancement has, in turn, had a profound impact on key
areas of health law and policy. This paper focuses on the historical
roots and current context of three interrelated areas: ethical allocation
of scarce medical resources; public financing of expensive health care;
and decisions to stop treatment for non-medically indicated reasons.
One of the earliest issues raised by the invention of modern dialysis
was the determination of who would receive the life-saving treatment
when there were more medically eligible patients than could be
accommodated.4 To make these difficult decisions, the medical team in
Seattle turned to an anonymous, unpaid group of community members
who came to be known as the God Committee.'5 The work of this
* Acting Assistant Professor, University of Washington School of Law. For their insights and helpful
comments, I am indebted to Christopher Blagg, M.D., Thomas McCormick, Christopher Sanford, M.D.,
and William Thieme, M.D. I am also grateful for the invaluable assistance provided by research
assistant Geoffrey William Hymans, Victoria Parker, and the University of Washington law librarians.
1. ALBERT R. JONSEN, THE BIRTH OF BIOETHICS 211 (1998).
2. Id.
3. Christopher Blagg, The First Dialysis for Chronic Renal Failure 50 Years Ago, 14 HEMODIALYSIS
INT'L 1, 2 (forthcoming Jan. 2010).
4. JONSEN, supra note 1, at 212.
5. Shana Alexander, Thirty Years Ago, 23 HASTINGS CTR. REP. (SPECIAL SUPPLEMENT) S-5 (Nov.
1993).

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