Alcohol abstinence policy for liver transplants discriminatory, Indigenous advocates say

Advocates say a policy that requires potential organ transplant recipients to abstain from alcohol for six months is unfair towards Indigenous people and people with alcohol use disorder.

David Dennis says the rule disproportionately affects Indigenous people and has teamed with the Union of BC Indian Chiefs (UBCIC) to take his fight to the BC Human Rights Tribunal.

Dennis, who suffers from end-stage liver disease, said he believed he was on the provincial waiting list for a new liver but it turns out he wasn’t.

“It’s one thing to be told that you’re going to pass away from this disease,” he said. “It’s another thing to be told, ‘By the way, did you know that you’re even not on the list?’”

According to BC Transplant’s policy, liver transplant recipients must be sober for at least six months in order to be eligible.

But Dennis and the Union of BC Indian Chiefs have filed a complaint with the province’s human rights tribunal, saying the policy “discriminates against Indigenous peoples, who have disproportionately higher rates of alcohol use disorder largely due to the centuries of racist and harmful colonial policies implemented at all levels of Canadian government, but especially through the intergenerational traumas of the Indian residential schools on Indigenous families and communities.”

“Indigenous people suffer higher levels of substance abuse,” UBCIC President Stewart Phillip told Global News. “It’s a fundamental issue with First Nations people and I think that should be taken into consideration when they make those incredibly difficult decisions on the list.”

A similar policy in Ontario prompted a court challenge, which led to a review of the policy. In 2017, an Inuk woman suffering from acute liver failure battled to overturn a six-month sobriety requirement for a spot on a transplant waiting list.

At the time, Dr. Atul Humar, director of transplantation at the University Health Network in Toronto, said one of the reasons for the widely-applied policy is that there is research suggesting some alcoholics who receive transplants will resume drinking, causing their new organ to fail.

“If someone continues to drink after [receiving] their liver transplant, they risk damaging that organ as well. The rationale is that if people can abstain for some time prior to a transplant, they can abstain for some time afterwards,” he said.

Dennis says there is little evidence to back the abstinence policy, saying “liver transplant outcomes are not meaningfully correlated with six months of abstinence from alcohol.”

In a statement to Global News, BC Transplant said it does not discuss details about individual cases due to privacy concerns, but it “will be reviewing this case together with the Liver Transplant Team at Vancouver Coastal Health.”
Dennis is hoping the health minister will listen or at least help him answer his young daughter’s questions.

“You try to explain why dad’s being taken away,” he said.

— With files from The Canadian Press

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