Nataline Sarkisyan becomes political football for debate over healthcare

The tragic death of a 17-year-old California girl has become an political football in the American presidential primaries. Democratic hopeful John Edwards brought her grieving parents with him on the campaign trail in New Hampshire and told listeners that she had died because of greed by a health insurance giant, Cigna. Progressive websites have taken up her cause: "Murder By Spreadsheet: CIGNA Denies Claim and 17-Year-Old Will Die," was the headline in the Daily Kos. However, the facts are more complex. Nataline Sarkisyan had been battling leukaemia for three years. She finally had a bone marrow transplant in November, but then her liver failed. Her doctors told her insurer, Cigna HealthCare, that she had a 65% chance of surviving for six months. The hospital was willing to do the transplant, but Cigna refused. After a tsumani of adverse publicity, it relented, but too late: Nataline died on the same day.

The case raised delicate questions about healthcare ethics. A leading transplant surgeon at the University of California San Francisco, Dr John Roberts, told the Los Angeles Times that his centre would not normally accept patients unless they had a 50% chance of surviving five years. And Dr John Ford, a lecturer at UCLA Medical School, noted on his blog that the figure of 65% seemed plucked from the air. A number of other doctors interviewed by the press said that Nataline’s case was marginal or even futile.

Other issues were raised by healthcare journalist Maggie Mahar: a leukaemia patient probably would not be cured by a transplant because of problems with immunosuppressant drugs; the UCLA transplant team has record of over-treating some of its very sick patients; little was said about the possibility that the transplant might leave the girl sick and in great pain. The Sarkisyan family’s lawyer now claims that Cigna "maliciously killed" Nataline. Whatever the facts are, Nataline’s death seems a weak peg on which to hang John Edwards’ healthcare policy.

Nataline Sarkisyan becomes political football for debate over healthcare

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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