Another organ dilemma so soon....

[wv_nurse 2003]

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

[baseline]

I can't face another one of these threads. :-(

[ktwlpn, LPN]

I said this earlier on that other thread-killers on death row should be donating organs-not receiving them... I might think twice about donating if this type of case becomes a trend-I think only one other prisoner received a transplant in Ca last yr.I don't remember the details of the case.I also believe that a life sentence should mean just that...LIFE IN PRISON and in my world if you are serving a life sentence you are only entitled to palliative care-for ANY ILLNESS...but that's just me-and my evil twin's opinion

[BadBird, BSN, RN]

I agree with above posters, I don't believe prisoners deserve a transplant especially at the tax payers expense. I don't have organ donator on my license anymore because I don't want my organs going against my will, I will decide when the time comes and so will my family but to a prisoner, no way.

[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:

[Q.]

I have mixed issues. While I don't believe that death row immates or whatever should even be getting the type of health care which would allow them the ability to have the transplant in the first place, my father is an alcoholic, trying desperately to turn his life around. 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?

[Mimi Wheeze]

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.

[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?

[sbic56, BSN, RN]

I don't know. It feels like selective humanity to give to only those who are "good." Felons usually get at least several years to life for their offenses. This is their sentance. As a donor, I don't think I have right to add to it by withholding my liver from them . Seems like double jeopardy to me.

[Q.]

Originally posted by sbic56

I don't know. It feels like selective humanity to give to only those who are "good." Felons usually get at least several years to life for their offenses. This is their sentance. As a donor, I don't think I have right to add to it by withholding my liver from them . Seems like double jeopardy to me.

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.

[sbic56, BSN, RN]

Brownms46

:) We must be one the same wavelength...I just entered mine and there was your reply!

[Brownms46]

:chuckle yes I noticed that as soon as mine came up!