Bob’s NewHeart

As I surfed the web looking for Blog ideas I ran across an old story with as many tentacles as a giant squid.  Each tentacle more controversial and thought provoking than the last. Just the two issues I’m covering here generate enough legal and ethical questions to keep law firms, bioethicists, lawmakers and editorial writers busy for hundreds of years. 

Issue number one:  In December of 2002 a twice-convicted armed robber received a heart transplant at Stanford University Medical Center in California at taxpayer’s expense.  Here’s an excerpt of the story from the British Medical Journal (BMJ) (Follow the link for the complete story).  http://www.bmj.com/cgi/content/full/324/7341/808/cDeborah Josefson Nebraska  April 6, 2002 British Medical Journal  “A Californian man has become the first prison inmate in the United States to receive a heart transplant, sparking a debate over the ethics of giving a prisoner an all expenses paid, lifesaving transplant when other citizens without sufficient funds or insurance are denied this opportunity.   In spite of the State of California’s expenditures and the Stanford University Medical Center’s expertise, the inmate transplant patient died a year later.  California corrections officials admitted he was “not a model transplant patient” and did not follow the strict medical rules laid out for transplant recipients.”

“What?” you say, “How can this happen?” Well, in 1976 the US Supreme Court ruled that prisoners have a constitutional right to equal medical care, stating that “deliberate indifference” to a prisoner’s health problems constituted cruel and unusual punishment under the provisions of the eighth amendment to the U.S. Constitution.  

The incident raises at least one very interesting question: If a convicted felon is entitled to our organs at our expense, should we be entitled to their organs without their permission  if they die while incarcerated?  If we want to alleviate the organ shortage the argument may have merit.  Right now there are about 2,200,000 prisoners in State and Federal prisons and jails.  That’s a lot of tissue and organs.  So, what’s your opinion?

Issue number two:  It has been suggested in several quarters that prisoners condemned to death should be able to bargain their organs for a reduction in sentence or perhaps reducing their death sentence to life without parole.  The discussion gained enough visibility to get the United Network for Organ Sharing (UNOS) to put the matter before their ethics committee. Here’s an excerpt from the UNOS Ethics Committee: Ethics of Organ Donation From Condemned Prisoners.  http://www.unos.org/resources/bioethics.asp?index=3 “Any law or proposal that allows a person to trade an organ for a reduction in sentence, particularly a sentence from death to life in prison, raises numerous issues. Application of the death penalty is spasmodic and seemingly discriminatorily applied, which would suggest that these types of proposals would be coercive to particular classes of individuals–minorities and the poor. Would the reduction in sentence apply to the offer to donate, or would it only be honored if the act of donation took place? If the act of donation would exclusively qualify for the reduction in sentence, then the law or policy would discriminate against individuals found to be medically unsuitable to donate organs.” The committee goes on to say, “Were prisoners allowed to trade a kidney to mitigate a death sentence, it may affect the actual imposition of the death penalty. With greater publicity surrounding these types of proposals/laws, potential jurors could be influenced and ultimately impose the death penalty more often with a potential societal benefit in mind. Jurors might hope that the convicted persons would choose to trade their kidney for their life. This would present a gross inequity for those unable or unwilling to donate a kidney and who might otherwise have not received a death sentence. In conclusion; the UNOS Ethics Committee has raised a small number of the many issues regarding organ donation from condemned prisoners. The Committee opposes any strategy or proposed statute regarding organ donation from condemned prisoners until all of the potential ethical concerns have been satisfactorily addressed.”   

Enough food for thought?  Obviously we need to increase the number of organs and organizations like UNOS (www.unos.org) and its offshoots; LifeSharers (www.lifesharers.org)  and others are doing what they can.  But, it’s not enough.  Too many people are still dying!!!  As a society don’t you think we have a responsibility to explore every available option.  Don’t you think we have a responsibility to “stop the dying” as soon as possible? Your opinion is important — please comment and encourage others to read and comment on these blogs.

If you are interested in the number of prisoners in your area and more information on prisons generally visit the Federal Bureau of Prisons site at  http://www.bop.gov/locations/weekly_report.jsp