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

Originally posted by fab4fan

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.

Fab4Fan...l am with you on this too.....the recent negative press has only served to reinforce my views against being a doner....primarily, my attitude has been greatly affected by some attitudes and statements of the staff of the organ donation society at large....l found them very distastful and offensive...LR

Specializes in ER, ICU, Corrections.

Most of the time, at least in our state...we give them medication for 1 month after they get out. Then they are on thier own, but of course the majority of them either go on welfare or the Oregon Health Plan which we pay for also. Very few of them get out and get a good job with insurance that pays for thier medications so all in all We the people of Oregon still pay for thier medications, just out of another part of the governments purse. :mad:

Originally posted by l.rae

Fab4Fan...l am with you on this too.....the recent negative press has only served to reinforce my views against being a doner....primarily, my attitude has been greatly affected by some attitudes and statements of the staff of the organ donation society at large....l found them very distastful and offensive...LR

Yep...my decision is also based on the behavior/attitudes of the people in charge of obtaining "donations." (hey, I'm gonna pm you more on this)

I was hoping those who have already decided

to be donors

don't change their minds

on account

of a couple of controversial transplantations.....

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

I was hoping those who have already decided

to be donors

don't change their minds

on account

of a couple of controversial transplantations.....

My confidence in humanity insists those swayed from giving such a valuable gift, because of a few controversial transplants, are few. (Yes, I like these rose colored glasses, thank you!)

Specializes in Everything except surgery.

:chuckle...let me borrow yours sbic...I can't find mine..:).

Specializes in Obstetrics, M/S, Psych.
Originally posted by Brownms46

:chuckle...let me borrow yours sbic...I can't find mine..:).

....passes the glasses:cool:

(I have been previously diagnosed with incurable optimism.)

Whether to donate your own organs or not to is just that, your choice. I hope that nobody has decided to not donate due to what has been in the news recently. Although, if your decicion WAS based solely on that it is still. . . your choice. They belong to you and you have the right to do with them as you please.

I choose to donate mine if the time and circumstances of my departure allow for it. That does not make me better than the person who chooses not to. It doesn't mean that I am more caring of an individual. It doesn't mean that I am a more nobel human being. It is just my choice.

For those of you who choose not to, don't let anyone at any time make you feel bad because of it! Your body, your choice!

:D

Leigh

Specializes in Obstetrics, M/S, Psych.

A most important point you mention, Leigh. Those who may not have it in them to donate an organ may be the giver of gifts just as valuable in a multitude of other ways! (Not that giving is ever mandatory, of course!) It would be a shame, though, if those who had previously decided to give the gift of life through organ donation, decided not to because of the off chance that the recipient may not be of their choice.

Specializes in Everything except surgery.

I agree with you both! Organ donation is a totally personal decision. But I don't think anyone here, said anything about it not being anyone's choice, or that anyone would be wrong for not donating their organs.

Yes I would like to see more become or continue to be organ donators. But not because someone else says, or beleives it's what they should do...but because it's their own desire to do so...period. It's your body....to do with it as you will ...in life or death.

OOh and thank you sbic for the glasses...:cool:

Originally posted by RNanne

I think that I will just keep my liver, thank you. I don't especially want it walking around in an alcoholic, heroin user, overweight, diabetic murderer.:rotfl:

Ditto from me. Think I will just keep my liver if that's how it's going to be. I will have to look into this closely and see what they are deciding to do. Thanks for the laugh RNAnne:roll

Originally posted by maureeno

I was hoping those who have already decided

to be donors

don't change their minds

on account

of a couple of controversial transplantations.....

No, not JUST because of that, maureen.

The Reader's Digest article that I read about organ donation a few years back (sorry, can't find it, but I tried to) that explained how certain companies processing the tissues were making mega-bucks did upset me.

And the thing with Erma Bombeck unable to get an organ (never drank, had a genetic disorder) but Mickey Mantle getting one inside of a few weeks--and then dying later, upset me.

And the fact that the general public just thinks, oh well, pop in a donor organ and all is well forever ---which is so wrong! with the medications and the lifestyle....

It isn't only my disgust at the unmitigated gall of this prisoner and her doctors to even try to get an organ over all the other people on the waiting list (and gawd knows, there aren't enough black people on the list anyhow!)---

No, Maureen, there are a few reasons. Good ones, I think.

If this is how it works, I think it's unethical and the system needs to be changed. Until then, I will not donate nor will I urge others to do so.

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