Another organ dilemma so soon....

Nurses General Nursing

Published

http://www.msnbc.com/news/878794.asp

Convicted killer's transplant sparks ethical debate

Many argue inmate is not entitled to donated liver

YORK, Neb., Feb. 28- Farmer Calvin Stock's life was saved by a liver transplant three years ago, and he would hate to see anyone else lose their chance at survival because a convicted killer was ahead of them on the transplant list. But that's exactly what could happen because of a Nebraska inmate's conditional approval to be included on the list of 17,300 people nationwide waiting for new livers.

FORMER PROSTITUTE Carolyn Joy, convicted of murdering another prostitute in Omaha in 1983, admits her liver was ruined by almost daily heroin and alcohol abuse over nine years.

Stock, a 68-year-old retired Lexington farmer who believes strongly in organ donation after it saved his life, fears people will tear up their donor cards if they learn their organs may go to felons.

"It's just going to do great damage to the organ donation program as we know it," he said.

The woman, known as Mama Joy by other inmates at the Nebraska Correctional Center for Women, has been the focus of a heated medical ethics debate since Omaha television station KETV first reported Feb. 3 that she had been evaluated by doctors for a possible liver transplant.

Joy, 49-years-old and drug free for nearly 20 years, said she is not surprised that others object to her possibly getting a liver.

"I know how society is," Joy said. "It's like, 'Oh my gosh, she's a murderer and on top of that, she wants one of our organs? What makes her so special?"'

TAXPAYERS TO FOOT BILL

But the biggest complaint from the dozens of people who have called or e-mailed the Nebraska Health System in Omaha, where Joy would get the transplant, is that the state would have to pay for it, said Kolleen Thompson, manager of the hospital's Organ Recovery Services.

Taxpayers would pay up to $200,000 for Joy's transplant because of a 1976 U.S. Supreme Court ruling that prisoners have a constitutional right to equal medical care. The decision requires government entities to cover the medical costs of their inmates.

A 32-year-old California inmate last year is believed to be the nation's first prisoner to receive a heart transplant. The convicted robber died 11 months later. Dr. Alan Langnas, head of transplant surgery at the University of Nebraska Medical Center, said doctors are only considering the transplant from the standpoint of whether Joy is medically a good candidate.

"Whether or not she's a prisoner or not does not enter the equation," Langnas said. "Ethically as a physician, it's our responsibility to be advocates for whatever patients we are treating."

Dr. Lainie Friedman Ross with the MacLean Center for Clinical Medical Ethics at the University of Chicago, said people should receive transplants based on need, not social standards.

"I'm a workaholic, and when I get my first heart attack I'll say I've earned it but no one will keep me off a list for that," Ross said. "We don't blame the workaholic but we blame the alcoholic. ... Yeah, she belongs on the list like I belong on the list."

Bill Grimes, 76, received a heart transplant 15 years ago and helped start a support group for transplant recipients in central Nebraska called Seconds for Life.

"I just absolutely can't pass judgment on anybody," Grimes said. "I feel everybody should have the same chance I had."

SHE MADE HER CHOICE'

But many do not feel as charitable toward Joy and her situation.

"She made her choice. It sounds real cruel to say that, but nonetheless, we all have choices in our life," said Stock. Whether Joy gets a liver will depend on her. Doctors have told the 5-foot-10, 195-pound woman that she must lose 30 pounds and get her diabetes under control before they will put her on a transplant list. She's already lost 70 pounds the last two years, some because of illness.

She's given herself until mid-April to meet both goals. Once the weather warms up, she plans to restart her exercise regime of eight laps around the prison courtyard twice a day.

"The doctors that I've seen said that I need to get busy and start doing what I'm supposed to or else I won't make it to see my liver come in," said Joy, who wears stocking caps to hide her thinning auburn hair.

Joy says she doesn't know if she deserves a liver. She believes she has paid her debt to society and answers only to her family and God. But she says she has trouble sleeping when she thinks about all the other people who need livers

"I want a chance just like they do," she said.

She said if she were to get a new liver and be paroled at her next hearing in 2006, she would take her 3-year-old grandson to the movies and looks forward to watching him grow into a young man.

Joy said she would consider passing up a liver to allow someone in a more dire situation to get one, especially if the person immediately behind her on the transplant list was a young mother.

"I'd step back and let that lady have the liver because she has a child," Joy said. "She has a life."

She also has made peace with the possibility she may not get the transplant and soon die.

"I'm not going to blame nobody," she said.

© 2003 Associated Press

Specializes in Corrections, Psych, Med-Surg.

Unfortunately, IMHO, the US Supreme Court has ruled that anyone held against their will by a government agency ( in a jail, prison, on a psych hold, etc.) is ENTITLED to taxpayer-provided health care. Taxpayers have NO choice in the matter unless and until that ruling is overturned.

konni writes: "Even children on Medicaid can't get organ transplants paid for by the state. They have to raise money from private donors. If the children who are being cared for with state money can't get an organ transplant paid for by the state, why should prisoners? "

A simple solution. All the child has to do is commit a serious crime, be convicted, and sentenced to an extended incarceration (no probations or acquittals will do it).

Specializes in Obstetrics, M/S, Psych.

Brownie

I think if one worries too much about determining what they believe someone elses fate should be, or that they may get something they don't "deserve", that someone may just end up being the one that ends up on the short end of the stick themselves. What goes around...

If it were to go to "someone worthy of it," than who do we put in charge of deciding if the transplant recipient is a good enough person to be permitted the second chance at life?

I'm not trying to cause arguements or anything, but I sure wouldn't want that job. Oh, sorry sir, but you drank away your liver so, too bad. Shoulda thought about what the consequences were earlier.

On one hand I agree with all of you that prisoners on death row do not deserve to get organ transplants, but on the other hand, I don't believe that illegal immigrants should be at the top of the list either. . . but we will leave that alone.

What it all boils down to, is how do you make an unbiased choice for who gets it and who doesn't if it isn't all just first come first serve.

Leigh

Specializes in Everything except surgery.

Yes sbic ...that is old saying...but a very true one in my experience.

And yes I have thought about who would be the one to make the decision, as who is more deserving of a transplant than another. Definitely won't keep many in that job for long. It's like the story of the old man, the young boy, and the donkey. No matter how they tried to please people....they ended up pleasing no one..not even themselves.

Forgive my ignorance, but what is the story of the old man, the young boy, and the donkey?

:confused: :uhoh21:

Leigh

Specializes in Everything except surgery.

:chuckle you know after I wrote that I had a feeling someone would ask.

The story goes like this:

An old man and a young boy set out one day, with the old man riding the donkey.

As they went along they came past some people who became anger, and shouted that the old man was wrong for letting the young boy walk.

So the old man let the young boy ride the donkey. As they went along they came across more people who shouted that the young boy was wrong for letting the old man walk.

So the old man and the young got on the donkey and they both rode. And they came upon another crowd of people who shouted at them because it was very hot outside...and they said to them, that they were wrong to burdened down the poor donkey with the weight of them both. So they both got off the donkey and walked.

As they went along they came across more people, who started LOL to see the old man and young boy walking. They cried out ..."What a dumb pair"! "They have a perfectly good donkey, yet they are walking."

So the moral of the story is...that no matter what you do...someone will see the wrong in it. Or you can never please everyone...no matter what you do:cool:

I'm rescinding my organ donor card.

Specializes in LDRP; Education.
Originally posted by sbic56

Being disected by students and then having the used parts incinerated is a better fate than becoming mere worm food.

Yup. Which is why I'm going to be cremated. :D

So, in fact a few of you here, are putting this woman on the death row, by refusing her the needed organ, don't you?

Since I am absolutely against the death- penalty and I find that, we are not the ones to judge over life or death, I would give this woman her needed organ. (when she is on the list, as everybody, who needs an organ should be)

Originally posted by Susy K

If, by a stroke of luck or grace, he did, and remained sober for 20 years (as this heroin user did), I would think he should get a liver transplant if needed. Otherwise, what really is the point to rehabilitation?

susy...she's sober for 20 yrs cuz she's been locked up for those 20 yrs....

Specializes in LDRP; Education.

Oh. Good point, Sunny.

Specializes in Obstetrics, M/S, Psych.
Originally posted by Susy K

Yup. Which is why I'm going to be cremated. :D

Oh, me too! It's a waste of real estate to do otherwise.

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