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 Obstetrics, M/S, Psych.
I still don't think we should be paying for their health care though. If a prisoner had the means to pay for a transplant, well then sure, he could get it. I think my gripe is having tax dollars pay for it.

I can see not wanting to pay for a transplant, but do you mean that for basic care, as well? Who would be respnsible? I think we are responsible to those we incarcerate to at least that much.

Specializes in LDRP; Education.

No, I think prisoners are entitled to basic care, such as First Aid type care, etc. All the same stuff we can get at the Health Departments, for example.

Originally posted by Susy K

This is a good point. Their sentence was just that, prison, not necessarily a death sentence by withholding a transplant to save their life.

Hmmm.

I still don't think we should be paying for their health care though. If a prisoner had the means to pay for a transplant, well then sure, he could get it. I think my gripe is having tax dollars pay for it.

The thing is, Susy, we, the taxpayers, would probably pay for that transplant...we pay for everything else for them, including getting a college education.

Originally posted by Brownms46

If they pay their debt to society..should they continue to be penalized for their crimes?

There is also the notion that there have been those who have been sentenced and shouldn't have been. Let's assumed someone needs an organ who was convicted of a crime and it was decided because they committed this crime...they shouldn't recieve an organ. Then later when it is too late, it's decided they didn't commit the crime. Would it bother anyone that they missed out on getting an organ because they were a convicted criminal at the time?? And because of a flawed system they will now die because of it?

If they're out of prison and rehabilitated, fine. But, personally, I don't want my tax dollars going for this when they're still in prison.

:stone

Specializes in Everything except surgery.

What I'm talking about is someone who could possibly not be guilty of the crime they are convicted of. But I still feel that allowing someone who has committed a crime not punishable by death...to die, because they happened to be in prison at the time they need a transplant, would be subjecting them to a penalty higher than they crime did.

As a taxpayer I have a problem with some of things we allow prisoners to get away with. But I just see keeping them from a transplant, as not being one of those things I object to. Except for those on death row that is...who have admitted their crimes and or there is no doubt they did it.

I don't think we should assess their penalty as being 5yrs and then say to them...well it's five years, only if you don't happen to need a transplant during those five years.

My biggest issue with this is using tax dollars for the transplant. They state prisoners should have "equal healthcare" with nonprisoners. But there are a lot of people out there working and paying taxes who are uninsured and have no means to pay for a transplant.

Originally posted by Brownms46

What I'm talking about is someone who could possibly not be guilty of the crime they are convicted of. But I still feel that allowing someone who has committed a crime not punishable by death...to die, because they happened to be in prison at the time they need a transplant, would be subjecting them to a penalty higher than they crime did.

As a taxpayer I have a problem with some of things we allow prisoners to get away with. But I just see keeping them from a transplant, as not being one of those things I object to. Except for those on death row that is...who have admitted their crimes and or there is no doubt they did it.

I don't think we should assess their penalty as being 5yrs and then say to them...well it's five years, only if you don't happen to need a transplant during those five years.

The chances of that are so slim, that I would still be against it. I think you're damned if you do and damned if you don't. But, if I think if it were left up to popular opinion, it wouldn't happen.

Why should this woman get a second lease on life when she has taken the life of another?

Specializes in LDRP; Education.
Originally posted by emily_mom

Why should this woman get a second lease on life when she has taken the life of another?

Bada-bing. If there is a line to be draw anywhere, then it should be those convicted of murder. As far as innocents being in prison, that needs to be addressed separately via our Justice system. But to go around assuming people in prison are innocent, thus should get transplants, is not something I can agree with.

Specializes in Everything except surgery.

Please do not take my posts to mean I feel this woman should get an organ after she took a life. That is totally not what I'm saying at all.

But some of the posts stated ..I think that they weren't in favor of prisoners getting transplants. That was the reason for my post above.

There have been many, many cases...where people have been found innocent ...after they have been convicted that it is scary. Especially in this day and age when DNA, has allowed those incorrectly convicted to go free. I guess I watch too many Forensic file like shows. :).

I agree with cyberkat. A friend of mine whos wife was awaiting a heart-lung transport was "laid-off" his wife and him could not afford to pay for the cobra benifits to keep her insurance going if not for the generosity of friends, family,and strangers. He would be widowed right now. I feel if a prisoner gets a life term with no parole if they need a organ transport --HECK NO. Give another person a chance not someone earned an eye for a eye.

Just another thought my friend pays about three hundred dollars a month out of pocket for the medication needed so Lori's body won't reject her new organs. Who wants to volenteer to pay this convict medication bill for the rest of her life if she recieves one.

Even she says she loses sleep at night thinking about it. If SHE has doubts ( or at least says she does), you can rest assured I do!

I was recently reading the story of kirk Bloodworth who was convicted of raping and murdering a little girl in Maryland. He was freed after spending 9 years on Death Row by proving he did not commit it with a DNA sample. He said that only seven people were proven innocent by DNA. He was asked about this case and said she shouldn't get the organ over another if one was found.

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