Lecture Vol. 12 - # 10 September 11, 1987 cover
Address by C. Everett Koop, MD, ScD
Surgeon General of the U.S. Public Health Service
U.S. Department of Health and Human Services
Presented to International Organ Transplant Forum
Pittsburgh, Pennsylvania
September 11, 1987
This was an international meeting, with 2000 people present. It was an opportunity for me to properly place President Reagan in the history of organ transplantation. I reminded the audience that it was his interest in the plight of Ashley Bailey, an 11-month-old baby on whose behalf the President made a nationwide appeal for a suitable liver.
One week before that appeal, President Reagan directed me to "conduct a conference on organ transplants," which I did and which firmly put this issue high on the public health agenda for the first time, where I might add, it still remains. I expressed my personal appreciation to the President and then turned to the second person to be honored that day, Dr. Thomas E. Starzl. Tom Starzl was not only a colleague, but also a friend and I had the pleasure of reading a letter from the President to him on his great accomplishments in the field of transplantation and how that had affected the health and life of the country. That letter is found as an appendix to this talk.
I then offered my own personal welcome to each of those who had come so far for this meeting, suggested the forum was perfectly timed, that we were cresting at a new high point in the history of this technology, and from this height, we could both look back and see how well we'd done, and also look forward in anticipation to the challenges and the mysteries ahead.
I then gave a rather breezy recollection of how the Surgeon General's Workshop on "Organ Transplantation" came about and I pointed out that the public - in its multiple roles of patient, family, and taxpayer - had already raised the issue of the role of science in contemporary life. They were asking if the newest developments in science were fueled by real patient needs? Were the priorities of science coincident with public priorities? Would the new developments of science be available to all who could benefit from them? Were they consistent with accepted social values? And did they uniformly support and strengthen the ethics of modem medicine?
The questions were not just transplantation questions, but they faced all of medicine. Although we were in our infancy as transplanters, I gave some statistics about what the coming year looked like and included the remarkable achievements in immunosuppressive therapy. This was another opportunity to laud Dr. Tom Starzl, because he demonstrated his leadership by coming forward with an equitable way - using a point system - of allocating available kidneys among the pool of waiting patients.
I made a plea to pool resources, share insights and people, to cooperate, to collaborate, and in all other ways to stretch and extend the limited resources we had in order to make the achievements of science available and accessible to all who could benefit from them. It was necessary to stress the role of the public, because ultimately, we were not only talking about the evolution of a technology, but also the evolution of public policy toward that technology, and eventually toward medicine, which is its host. I saw that process begin at the first Surgeon General's Workshop. I mentioned the rational initiative to establish the American Council on Transplantation, which was described in a previous lecture in this archive, as well as to support an umbrella organization, the "United Network for Organ Sharing" - the UNOS.
There is another appendix to this talk. The latter half of this talk had been done in a delivery that was breezy, collegial, friendly, etc. Later, I had a request from the University of Pittsburgh the home base of Dr. Tom Starzl, for a recap, not so much asking rhetorical questions, but as statements of fact. This recap was provided to the University of Pittsburgh on November 2, 1987.