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

Before she is even put on the list, the Drs. said she had to lose 30 lbs and get her diabetes under control and she's giving herself until mid April to accomplish these goals. Drs told her to get busy and start doing what she's got to do or else she won't make it to see her liver come in. Eight laps around the prison courtyard 2x/day? If her liver is that damaged I would think she'd have SOB upon mere exertion. And will she ever get her diabetes under control with a damaged liver as bad as hers? Probably not.

My guess is that she won't even make the list at this point.

Having taxpayers foot the bill for prisoners who want transplants? It's a pitiful America isn't it?

Her next parole hearing is in 2006...will she even make it?

Well I for one would like to have Semstr come to nebraska and foot part of the bill for her getting this surgery. I do agree she probably will not make the changes to be put on the list but, on the off chance she does I do not want to pay for it or the follow up care. I feel my tax dollars can go for better things. I wish our Govenor would step in and say no but that would be like keeping up with issues in this state other than the ones he creates. STOP THE INSANITY!!!!!

Specializes in Everything except surgery.
Originally posted by semstr

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)

.....although I do no strongly believe in the death penalty, since I believe it should only be used in certain cases. I tend to believe this woman signed her own death warrant...by her own actions. I beleive if she really cared about living, she wouldn't have waited until the last minute to try, and correct the abuses she has done to her body...IMO

Specializes in LTC,Hospice/palliative care,acute care.
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?

First point-this woman is in prison with a life sentence which as I have stated -IMHO-really should mean LIFE and does not....Secondly-we are not talking about someone whom has paid her debt to society-she is still in there and unless she gets parole will stay there...Third-if we want to cloud the issue further and talk about the innocents wrongly imprisoned let's look at the other side of the coin -I'll just have to say....O.J. Simpson...Our system is not perfect-but we have to accept it as it is until we can get it changed...As for drug addicts and alcoholics I believe that If they can kick there habits for a pre-determined length of time then they should be able to qualify for a transplant-If they drink or drug themselves to death's door and won't live through that period of sobriety-then they should not be eligible for a transplant....These are just some of my ideas for fixing the system-when I have had a glass or 2 of wine I HAVE ALL OF THE ANSWERS!
Originally posted by ktwlpn

...As for drug addicts and alcoholics I believe that If they can kick there habits for a pre-determined length of time then they should be able to qualify for a transplant-If they drink or drug themselves to death's door and won't live through that period of sobriety-then they should not be eligible for a transplant....These are just some of my ideas for fixing the system-when I have had a glass or 2 of wine I HAVE ALL OF THE ANSWERS!

on this note...i remind people again that even if this woman were freed from prison after her transplant (HYPOTHETICALLY!!!!!!!!) although she has been sober for 20 yrs...she has been in the pen for those 20 yrs....i'm gonna go crack open a bottle of Riesling and see if i can help ya solve the ills of the world....:chuckle

Specializes in LTC,Hospice/palliative care,acute care.
Originally posted by sunnygirl272

on this note...i remind people again that even if this woman were freed from prison after her transplant (HYPOTHETICALLY!!!!!!!!) although she has been sober for 20 yrs...she has been in the pen for those 20 yrs....i'm gonna go crack open a bottle of Riesling and see if i can help ya solve the ills of the world....:chuckle

Good place to kick-although my cousin the prison guard says they make hootch out of every piece of kitchen scrap they can get their hands on...Any way-in my world-a prisoner would not qualify any way...My rule applies to civilians.... If you drink that whole bottle you'll be able to go straighten out that mess in Iraq-If I had a few pitchers of margaritas I could set North Korea back on track.... ;>)

North Korea...fear ktwlpn...LOL!

Now, if someone can stay clean for 20y after he gets out of the pokey, then that will be something!

Specializes in Everything except surgery.
Originally posted by ktwlpn

First point-this woman is in prison with a life sentence which as I have stated -IMHO-really should mean LIFE and does not....Secondly-we are not talking about someone whom has paid her debt to society-she is still in there and unless she gets parole will stay there...Third-if we want to cloud the issue further and talk about the innocents wrongly imprisoned let's look at the other side of the coin -I'll just have to say....O.J. Simpson...Our system is not perfect-but we have to accept it as it is until we can get it changed...As for drug addicts and alcoholics I believe that If they can kick there habits for a pre-determined length of time then they should be able to qualify for a transplant-If they drink or drug themselves to death's door and won't live through that period of sobriety-then they should not be eligible for a transplant....These are just some of my ideas for fixing the system-when I have had a glass or 2 of wine I HAVE ALL OF THE ANSWERS!

Number one:

I referred to the possibiliy of someone being innocent ..though convicted...to the post stating that prisoners should not listed last on a donors list or just not get a transplant period:

Mimi Wheeze

Senior Member

Registered: Jan 2003

Location: Indiana

Posts: 106

Post #7

I think your father should get a liver if he needed one! However, if he was a convicted felon I may think otherwise.

I have always been "pro-donor" but if crap like this goes on, I may change my mind. Prisoners should be last on the donor list, period

emily's_mom -

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.

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.

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.

But yes I beleive that 20yrs and or life...should mean just that! I believe it cheapened the judical process when the sentences that offenders get...isn't even close to what they actually serve.

Specializes in LTC,Hospice/palliative care,acute care.
Originally posted by

But yes I beleive that 20yrs and or life...should mean just that! I believe it cheapened the judical process when the sentences that offenders get...isn't even close to what they actually serve. [/b]

Yepper.... But let me ask-a prisoner serving a 10 or 15 yr sentence-what kind of medical care should they be entitled to? Better then what medical assistance provides? Making someone in that position eligible for a transplant is saying just that-and when their sentence is up what happens then? Hard to get a job with insurance these days and the transplant would be a pre-existing condition.So does the state continue to pay for the meds or do they just chalk that one up? This just goes on and on....Let me throw something else on the table-Who says prison is NICE? Our local county prison has cable TV for goodness sake-but the county run LTC does not.... Prison should be a punishment-not a vacation.I think that if you commit a crime and are serving time then you should be forfeiting things like medical care(other then basic palliative care) Got a toothache?-out it comes...No filling-no root canals-no caps...Just a cheap yank... Got a tumor?-here's some pain med....sorry about your luck....

I hope those talking about not being organ donors because of a very few exceptional instances of 'unworthy' transplantations are only just venting and not serious.

Specializes in Everything except surgery.

I agree about the tooth and I agree about the cable. I also never thought about the fact that once the person gets out of prison. But I doubt...but maybe wrong here, that the prison would continue to pay for such care, after the sentence is completed. I also don't agree about the tumor. But at least we agree on a couple of points:cool:

Originally posted by maureeno

I hope those talking about not being organ donors because of a very few exceptional instances of 'unworthy' transplantations are only just venting and not serious.

Well, I am not an organ donor, and like I said do not expect to get an organ if I needed it. My reasons are not just because of who gets transplants, but they are my reasons, and just as valid as those of people who want to donate.

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