In 1960, when Scribner saw a young man recover after dialysis, only to die shortly thereafter, he was deeply troubled. At that time dialysis was nothing more than a temporary fix, with glass tubes being used to carry the patient's blood to the dialysis machine and back. Not only was the procedure extremely painful, it also destroyed the patient's blood vessels. After just a few dialysis treatments, the patient had no remaining healthy blood vessels through which to receive treatment. Scribner wrestled with the problem nonstop. Then, in the middle of the night, he awoke with a start - he had an idea: he would create a loop that would allow a patient to receive multiple dialysis treatments. The loop would run between an artery (carrying blood away from the heart) and a vein (returning blood to the heart), serving as an entry point for the dialysis connection. This loop, known as the "Scribner Shunt," would remain permanently in place, thus avoiding the damage to the patient's arteries, and making ongoing dialysis treatments possible for the first time. Scribner's final stroke of genius came in his selection of the material Teflon for the shunt. Ironically, Scribner chose the relatively unknown material because a colleague told him it would not react with human tissue. It wasn't until later Scribner realized the most significant advantage of Teflon: its non-stick properties meant the blood would not clot, which had been a major problem with the glass shunts. The Scribner Shunt, first envisioned in a middle-of-the-night revelation, has since saved millions of lives.

Scribner was unaware of the dilemma he was about to face. His shunt was a tremendous success, literally offering a reprieve from death to the sickest patients. But that led to the question of which patients? There were not enough dialysis machines to meet the need, and the cost of the treatments was far beyond what most could afford. Scribner enlisted the help of the King County (Washington) Medical Society, which established "The Life and Death Committee." This committee, meeting privately and possessing irrevocable authority, made the difficult decisions about who would - and who would not - receive the lifesaving dialysis treatments. It was a bitter pill for Scribner to swallow, but at the time he felt he had no choice. However, he would remain a lifelong advocate for universal access to medical care. It was largely through his efforts that Congress enacted legislation, in 1973, that authorized reimbursement by Medicare for dialysis. Many view this dilemma, known as the "Seattle Experience," as the beginning of the field of bioethics.
 

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