In both his Iowa and New Hampshire prime time TV concession speeches, and probably on the stump as well, Democrat presidential candidate John Edwards has, with manifest stage anger drawn deeply from the well of his trial lawyer heart, lashed out regarding the case of Nataline Sarkisyan.

As Edwards starkly spits out the story, Nataline was a 17-year-old girl who needed a liver transplant. Her parents had health insurance, but the insurance company wouldn’t pay for the transplant. The family, along with doctors and nurses, fought back. But by the time the insurance company finally gave in, Nataline had lost her life.

Forget the details. Candidates routinely do, if they even know them. A percentage of people believe the version they hear, as they are intended to. Mission accomplished.

Whatever the nuanced, detailed reality, it will come later, often much later, with far less prominence and impact, and will do little to displace the contrived, induced belief in John Edwards’ “Two Americas” or similar societal divides that are exacerbated, then exploited by others.

In the case of Nataline Sarkisyan, perfect for demagogues like Edwards, the details are shrouded by the umbrellas of patient confidentiality and litigation.

Two journalists – Molly Hennessy-Fiske in the Los Angeles Times and David Whelan for Forbes.com – have tried to penetrate the story, but beyond overall outlines have been able to provide no definitive answers. But both raise a host of questions that point to a far more complicated series of events and judgments than are encompassed in John Edwards’ one-sided, demonizing rhetorical broadside.

When she was 14, Nataline Sarkisyan contracted leukemia, which went into remission but returned, resulting in a bone marrow transplant last November from her brother, which again put the leukemia in remission. But then her liver failed, and she was placed on life support, pending transplant, which was sought by her doctors.

The insurer, Cigna HealthCare, first refused the transplant payment request on the basis that it would be “experimental,” but when Cigna reversed that decision, agreeing to the payment, Nataline Sarkisyan’s family had taken her off life support, filing a lawsuit against Cigna the next day, represented by the well-known California attorney Mark Geragos.

While Sarkisyan’s doctors and hospital (UCLA) have maintained silence absent a privacy waiver from the family, other specialists interviewed by Hennessy-Fiske indicate the very real dilemma: “Dr. John Roberts, chief of the transplant service at UC San Francisco, said Cigna faced a difficult decision in the case, based on the facts presented by the UCLA team.

“Roberts said his center generally will not accept a patient without a 50% chance of living five years. According to UCLA’s letter to Cigna, patients like Nataline had a 65% chance of living six months.”

Whelan writes: “The mysterious part of the narrative is whether a liver was truly ready to be transplanted. If there was a liver, why was it held up? It’s not enough for the insurer to deny coverage. The doctors and the hospital – especially a nonprofit institution like UCLA – must decline to work for free.”

In the real world of critical medical care, there are questions, there are judgment calls, there is the necessary understanding of detail and there is inescapable sympathy for the Nataline Sarkisyans and their families. There is also justice to be meted out, when necessary, hopefully on the basis of facts, not political campaign rhetoric.

There is rarely just the simplistic, manipulated contrast of good vs. evil that does no service to the considered discussions we must have over such issues, and brings no credit to those like John Edwards who serve only their own needs by exploiting the tragedy of others.