In Alvin Moss’ and Mark Siegler’s article, “Should Alcoholics Compete Equally for Liver Transplantation?” they state that patients who develop end-stage liver disease (ESLD) should have higher priority for liver transplants than those who develop alcohol-related end-stage liver disease (ARESLD). I will reject Moss’ and Siegler’s view that alcoholism is a disease and explain why it is a choice.
I will begin by explaining Moss’ and Siegler’s argument for prioritizing liver transplants for people with ESLD over people with ARESLD. Due to the scarcity of donor livers, they claim that it would be unfair to allow those with ARESLD to receive more than half of them. They would rather prioritize patients who develop ESLD from primary biliary cirrhosis than those who suffer from alcoholism. Moss and Siegler believe that even though alcoholism is a disease, alcoholics should be held responsible for refusing alcoholism treatment and relying on new organs to help them. They understand that alcoholics cannot be held responsible for their disease, but they can be held responsible for seeking treatment to prevent it from reaching the point of ARESLD.
Next, I will reject Moss’ and Siegler’s view that alcoholism is a disease and explain how this counteracts their argument. It seems self-contradictory for Moss and Siegler to hold the position that alcoholism is a disease yet it is also something that people should be held responsible for treating. The reason I believe this position is untenable is because claiming that alcoholism is a disease means that alcoholics have no control over it and therefore should be treated equally to other people suffering from diseases. However, Moss and Siegler believe that people do in fact have control over their alcoholism, which is essentially saying that they are responsible for it. Even if that responsibility is how they treat it before it reaches the point of ARESLD and not the responsibility of developing alcoholism in the first place, there is still some level of responsibility. Therefore, if a disease is something that is completely out of someone’s control, then I believe it is incoherent to claim that they should be held responsible for it on any level.
I will now explain why alcoholism is not a disease but rather a choice. I find it suspicious that alcoholism being a disease is even up for debate because real diseases are diagnosed through scientific bases. Yet alcoholism is based on theories and factors that people only suspect to be true such as environmental or physiological factors. For example, many believe that there is an “alcohol gene” and if someone has this gene they should never drink or else they will “catch” the disease of alcoholism. Having a disease does not begin with a chosen behavior such as picking up a glass of wine. Claiming that alcoholism is a disease is a way for alcoholics to not take responsibility for their own actions and face the problems they cause themselves and others. In addition, there are many individuals who stop drinking altogether or even in moderation and never return to the “disease.” Putting down the drink does not mean that someone has cured a disease, it simply means that they made a choice not to drink.
In conclusion, I agree with Moss’ and Siegler’s argument that those with ELSD should be prioritized for liver transplants over those with ARELSD. However, Moss and Siegler believe that alcoholism is a disease and I believe that it is a choice. Moreover, if Moss and Siegler truly believe that alcoholism is a disease, then they should not hesitate to treat those with ELSD equally to those with ARELSD with no prioritizations.