Should Violent Felons Receive Organ Transplants?
by David L. Perry, Ph.D.
On January 3, a convicted felon was given a new heart at Stanford Medical
Center. The cost of the transplant and years of post-operative care may
reach $1 million, courtesy of California taxpayers.
Most people would no doubt find it troubling that a criminal would get
a major organ transplant while hundreds of law-abiding citizens who desperately
need that organ are made to wait. Imagine watching a loved one die for
lack of a heart, then reading in the paper the story about our fortunate
But according to Russ Heimerich of the Dept. of Corrections, as quoted
by Steve Wiegand of the Sacramento Bee (25 January 2002), "The
courts have told us that inmates have a constitutional right to health
care. The judge did not sentence this guy to death. And who knows, he
may get out and become a productive citizen."
Wiegand went on to explain, "In 1976 the U.S. Supreme Court held
that deliberate indifference to a prison inmates health
problems constituted cruel and unusual punishment and thus violated the
Eighth Amendment to the Constitution. Since then, hundreds of subsequent
cases have established that inmates have a right to medical care equal
to that of the public in general."
Now, I can imagine situations where denying basic medical care to a prisoner
would indeed be cruel and unjust. We may not keep antibiotics or painkillers
from prisoners and still call ourselves a compassionate, civilized society.
But Im not persuaded that the Supreme Court intended to give violent
criminals a claim equal to that of the rest of us on highly scarce medical
resources like hearts, livers, lungs and kidneys, especially when the
decision to save one persons life with an organ transplant almost
inevitably means that someone else will die. The unprecedented
decision of the California Dept. of Corrections to give the convict a
heart transplant evinced questionable legal judgment.
Moreover, that prisoner had been [twice] convicted of robbery. While
not a capital crime, robbery implies at least the threat of injury or
death to its victims if they dont comply with the robbers
demands. In my view, those who deliberately threaten the lives of innocent
persons thereby forfeit whatever moral claim they otherwise might have
had to an organ transplant.
The question here is not whether the convict might one day become a "productive
citizen," though we might certainly hope that his "change of
heart" would be more than merely physical. It would be morally repugnant
for society to allocate organs based on estimates of persons "social
Further, we need to reform our justice system to minimize the chance
of an innocent person being wrongly convicted of a violent crime and thus
being denied an organ transplant.
In general, organs should be distributed according to 1) degree of need
and 2) probability that the transplant will be successful. But unlike
most other medical treatment decisions, those regarding organ transplants
ought also to take into account 3) a history of violent crime. I think
we can agree that if we knowingly commit such crimes and thus violate
others basic rights not to be harmed or killed, we lose the right
to an organ transplant when it could save the life of an innocent person.
Finally, we can help alleviate the dire scarcity of organs in concrete
ways: increasing their supply by becoming organ donors and informing our
families of that; and decreasing our demand for organs by living healthier
livese.g., exercising, not smoking, and not drinking excessively.
Lets save organ transplants for nonviolent citizens who need them
through no fault of their own.
This op-ed was published in the San
Jose Mercury News on 31 January 2002 under the title, "Criminals
Should Be Far Down on the Heart Transplant List."
David Perry is Director of Ethics Programs at the Markkula Center
for Applied Ethics and Lecturer in Religious Studies, Santa Clara University.
None of his views should be construed necessarily to reflect those of
the Ethics Center or SCU.
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