On January 23, 1996, at the Stanford University Medical Center in Palo Alto, California, 34-year-old Sandra Jensen underwent a heart and lung transplant—an operation she had fought long and hard to obtain. Jensen has Down’s syndrome, a chromosomal disorder that usually results in mental retardation and often causes congenital heart defects. Today, most children with the Down’s syndrome heart defect undergo corrective surgery, but when Jensen was born this medical technique was unavailable. Over the years, her heart and lungs deteriorated to the point that she could not survive without an organ transplant, and she applied to the waiting lists of the transplant programs at Stanford and at the University of California at San Diego (UCSD) Medical Center.

However, because of the long waiting lists for heart-lung transplants, hospitals regularly reject patients who are not considered...