Delilah Saunders hopes to head home after being denied spot on liver transplant list

Delilah Saunders was transferred from ahospital in Ottawa to one in Toronto on Friday, but in a Facebook post Monday night said she is improving and plans to head back to her home province.

"Feeling like gunk and not entirely out of the woods but just wanted to update you that my liver is improving," she wrote. "Thank you all, nakummek for the support and love you all! Also, I'll be moving to NL to heal."

Saunders's mother said theInukactivist wasdenied a spot on a liver transplant waiting list, which was hard on her daughter.

Her friends and family say she was denied the spot because of a requirement that transplant recipients be sober for the preceding six months.

• Condition of Delilah Saunders shows slight improvement, friends say
• Woman in critical condition from liver failure can't get transplant due to protocols

"Last night she had a really bad night,because she realized what situation she was in, that her liver was gone and it was possible that she would die," Miriam Saunders, Delilah's mother, told CBC's Here & Now on Monday night. "She hadn't slept last night because she was upset that she knew that she wasn't able to have a liver transplant."

We're still not out of the woods yet, and we're waiting on more feedback from doctors to determine what the next steps must be.- Caryma Sa'd

Miriam Saunders said her daughter an advocate for Indigenous rights whose sister Loretta was murdered in 2014 had been taking Tylenol to help with the pain of infected wisdom teeth, and that was what caused the liver failure.

Caryma Sa'd, Delilah Saunders' lawyer, said she and the family have been encouraged to see some improvement in her condition.

"We're still not out of the woods yet, and we're waiting on more feedback from doctors to determine what the next steps must be," she said, adding that family and supporters have offered to donate.

"People in the immediate family, and extended family, certainly have come forward, and I understand that there have been others as well who have been touched by the story and want to see the right thing done and wish to be a part of it," she said.

Saunders' denial has opened a debate on the ethics around organ donation, but an assistant professor of bioethicsat Memorial University's faculty of medicine says it's a problem people have been grappling with for a while.

"Some hold the view that it's morally relevant that people in this kind of situation have according to this view brought on the situation themselves, they've engaged in avoidable behaviour," Dr. Jennifer Flynn told CBC'sOn the Go on Monday afternoon.

Issue complex because of scarcity of livers

"And so it's possible that the claim that they have on these medical resources in this case, a liver is less than the kind of claim that someone who wasn't in this situation would have on that resource."

The question is made tougher because of the scarcity of livers available for transplant, said Flynn.

"If one person is a liver recipient, it means another person is not," she said. "And given the fact that one has brought one's condition on one's self, there's a moral weight to that, and that person is somewhat less deserving of that liver than someone else who needs it for another kind of reason. I'm not taking that view; this is a view that's out there."

That view carries an assumption that alcohol use is always a choice, she said, but the other argument is that alcoholism which people develop for many reasons is not a choice.

Difficult to separate moral and medical issues

"Some people would say that it is oversimple to assume that one is entirely responsible for developing an addiction in the first place, and, further, it's problematic to assume that once one is in the grips of an addiction that the conduct in which they're engaging is easily avoidable."

It's difficult to separate the moral and medical issues at play, she said.

"Some people would say it's professionally and medically and morally incumbent upon us to choose transplant recipients who maximize the chances of a transplant being successful," said Flynn.

"Someone might hold the view, 'Look, I have lots of sympathy and compassion for any particular person in this situation' the situation that's akin to this case that we're discussing 'but as a medical professional I want to choose the recipient who's going to maximize the chances of this transplant being successful."