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A New Heart, or Liver, For a Convict

W. Victoria Lee

Imagine you die in a car accident. Because you are a rational and generous citizen, you have indicated an organ donation on your driver's license. Doctors remove all your usable organs, including your heart. This heart, still warm, is immediately prepared for transport to another hospital where a patient is getting ready to receive it. Watching this from above, you smile and are glad that your misfortune has turned into someone else's fortune. This patient is no different from the other 80,000 patients in the nation on the waiting list for an organ transplant: bed-ridden, dying, and desperate. The only thing that might set him apart from the others is that he is an inmate, a man who has committed unforgivable deeds against our society. Would you still be smiling?

But then imagine yourself as an inmate who is currently serving a sentence for crimes committed during your youth. You have since resolved to be a better person and are looking forward to your imminent eligibility for parole. The only thing that stands in your way is your failing heart. You are told that you need a new heart, but you are also told that you will be placed on a separate waiting list, a list just for inmates. Patients on this list can only pray that someone among the one-third of the people who die with reusable body parts is willing to give his or her organs to an inmate. Would you consider this discrimination, or a violation of human rights?

You probably have not pondered these questions yet; neither did I until recently. A Californian convict, the first inmate to receive a heart transplant while serving his 14-year sentence for robbery, died a few months after his $2 million taxpayer-funded surgery and medical care. Outraged by this “waste“ of the otherwise perfectly reusable heart and money, and inspired by his father's death while waiting for a liver transplant, California State Sen. Jeff Denham proposed a bill to give California organ donors the freedom to decide that their organs not go to inmates. He argued that donors would like to know that their deaths have brought lives to those who will contribute to society, and not to those behind bars who have not only failed at that task but have instead brought harm. Denham recently told the Los Angeles Times that he had reports of angry Californians tearing up their organ donor cards upon discovering the state-funded transplant.

Indeed, would you want to give your organs to an ax murderer or child molester? Some would say keeping organs from inmates is inhuman, that the prisoners are human too, and that they deserve organ transplants just like other patients do. However, we take away prisoners' ability to vote and other rights held by most citizens, and nobody is jumping up and down denouncing the inhumanity of such punishment.

Until 1996, every patient who needed an organ transplant was placed on the same waiting list. After the former “Dallas “ star Larry Hagman received a new liver, outrage brought the United Network for Organ Sharing to the decision that people who require liver transplant due to excessive use of alcohol and drugs will not be placed on top of the waiting list. Such restriction has happened before,and it might happen again. In the USA, every 90 minutes a patient dies waiting for an organ transplant. How do we decide who gets the next available organ? A spokeswoman for the California Transplant Donor Network answered this question in a Los Angeles Times article: “organ allocation system is based solely on medical and scientific criteria, not on which patient is the richest, the smartest or the most socially acceptable.” Fair enough. But can we choose to whom we want to give our organs? After all, the organs are ours.

It is assumed that when we signed up to become organ donors we expressed our wish to help the patient who most needed the organ, and doctors can accurately and fairly determine who needs an organ most. The real problem is deciding who most deserves the organ. How do we determine whether one life is more worthy than another? Just because one is imprisoned does not necessarily mean that he or she is more morally corrupted than a free businessman who embezzles and deceives. Is a robber who takes good care of his elderly parents more immoral than a politician who lies to the public and neglects his family? Wrongful accusations and undeserved freedom happen; we cannot give an accurate moral judgment of people based on one or two events in which they have participated. On the other hand, it is not so practical to invest the gift of an organ and to spend millions of taxpayers' money on a serial killer sentenced to life or even an inmate who is on death row. Of course, the possibilities that these prisoners have been wrongfully accused and the real criminals are running free exist. In a real world where anything is possible one can only work with what one knows, but significant effort should be made to ensure the final decision is not driven by impulsive emotion and stereotypes.

Not every inmate deserves a second chance to live and not every immoral, undeserving person is behind bars. Where do we draw the line as to whom the donated organs should go? We don't. Erase the line, forget the yes-no options, and treat it case by case.