Another prisoner´s dilema: Donating organs in jail


Hello, I will write about two thought provoking situations regarding organ donations that have actually taken place in the United States and would like to hear your opinion about them.

Is it efficient for prison inmates to have the right to be on the transplant list?

Even though prison inmates face a clear limitation of some of their rights they still have the right to receive medical care. So if an inmate has kidney failure and is in need of a transplant he has two options to stay alive: to receive a treatment called hemodialysis or to receive a kidney transplant.

UCST, the University of California San Francisco, estimates that hemodialysis treatment, a machine that filters your blood, costs an average of $89,000 per patient annually in the United States. On the other hand the average cost of a kidney transplant is $32,000 for the transplant surgery and $25,000 per year post-surgery to care for the patient and ensure the transplant is not rejected. It is important to note that the federal government, through Medicare, stops paying for the rejection medicines 3 years after the transplant. It is therefore cheaper for the government to pay for a transplant than to pay for hemodialysis. So is this the efficient alternative?

Imagine that you want to donate your organs after your death. Would you still want to do so if you knew beforehand that they could go to a jail inmate? Wouldn’t this cause, or is already causing a reduction in the number of persons willing to donate?

It is easy to be sympathetic to the protests and anger of the parents of a 10 year old boy, who suffers renal failure, when they hear that the kidney that their son was about to get has been redirected to an inmate who was convicted of rape and assault. The inmate got very ill all of the sudden and is now at the top of the transplant list. It will probably be said that the kids life, or any other person for this matter, is worth more than the life of a criminal. This is why the transplant list in the United States only considers the medical condition of those in it and assigns organs based solely on medical facts in order to prevent comparing the value two different lives could have for society. With more than 100,000 patients in the United States on the kidney transplant list but only 20,000 available donor kidneys per year, giving the kidney to the inmate could mean sentencing the boy and many others waiting for a transplant to die.

Should death row prisoners be able to donate their organs after they are executed?

In an article published by the New York Times “Giving Life After Death Row”, Christian Longo who murdered his wife and his three children and was sentenced to death row tells us how his petition for donating his organs was denied. The prisons authorities stated that “The interests of the public and condemned inmates are best served by denying the petition.”

One of the reasons they might have done that is that the lethal injection sometimes damages the organs making them unfit for donation. But it all depends on the chemical components used in it. Should the government then use lethal injections that don’t damage the organs or devise another way of killing the prisoners so their organs are fit for donation?

If the donations from death row inmates were allowed would it create perverse incentives where death row inmates are coerced and abused so they donate their organs?

So what do you think, what efficient thing to do?



Hi Alejandra,

I think donation can also be part of rehabilitation, preparing a prisoner for eventual freedom though thoughtful decision-making and, ideally, restitution. Finally, justice is served by allowing people to repay their perceived debt to society in reasonable ways that they see fit. With all the constraints placed on prisoners – some necessary and important, others capricious – why prevent them from making a choice that in their eyes represents atonement and also frees a sick person from the prison of dialysis?

As for donations at death from prisoners on death row, consider the case of Christian Longo, who awaits execution at Oregon State Penitentiary. In 2001, Longo killed his wife and three children. For years, he has petitioned the state to let him donate. He said:“There is no way to atone for my crimes, but I believe that a profound benefit to society can come from my circumstances".

Refusing Longo this opportunity may make sense to those who believe that a person who committed a monstrous crime should be denied any thing he desires. But the fact that Longo’s act could mean life for others should tip the balance in favor of granting him this last wish.

What do you think?