“How many of you think we should do liver transplants for alcoholics?”

About half the hands were slowly raised, while the other members of the class looked around nervously. These were third-year medical students, and I was giving my monthly lecture on organ transplantation.

“How many of you think the potential recipient should have six months of absolute sobriety before being offered a transplant?”

This time, the majority raised their hands, and a look of confidence could be seen on most of the students’ faces.

“But what if they won’t live six months? What if the patient is a 37-year-old mother of three, or a 26-year-old college graduate who didn’t realize the damage he was doing to his liver? Would you stand over the young man, with his parents watching, and tell him you could save him but you’ve decided he doesn’t deserve it?”

I continued: “How many of you think alcoholism is a disease?” Almost everyone raised his hand.

“What do you think the recurrence rate of this disease is after liver transplantation?”

A few people guessed about 20 percent, which is roughly accurate.

“How many of you think hepatitis C is a disease?”

Everyone.

“And the recurrence rate of that after transplant?”