State inmate gets new heart
By Steve Wiegand -- Bee Staff Writer
A California inmate has become the first person to receive an organ transplant
while in state prison, adding fuel to the debate over the costs of providing
medical care to an expanding, and aging, prison population.
Published 5:30 a.m. PST Friday, Jan. 25, 2002
In an operation performed without fanfare at the Stanford Medical Center
three weeks ago, a 31-year-old two-time felon was given a new heart.
The taxpayer-financed operation and subsequent aftercare, which prison
officials estimate could carry a total price tag of $1 million, is certain
to raise questions as to whether there are limits to the kinds of treatment
ailing inmates must be given.
"We don't have a policy per se," said Russ Heimerich, a spokesman for
the California Department of Corrections. "We have a requirement, based
in law and in losing many, many lawsuits, to provide medically necessary
care to inmates.
"The courts have told us that inmates have a constitutional right to
health care. You and I don't, but inmates do. ... We have to do whatever
is medically necessary to save an inmate's life."
The inmate, whose name is being withheld by the department for reasons
of medical confidentiality, is serving a 14-year sentence for a 1996 robbery
in Los Angeles. Prison officials say he will not be eligible for parole
until late 2008 because this is his second felony conviction.
After a longtime heart problem caused by a viral infection became critical,
he was transferred to the Stanford Medical Center from the prison system's
medical institution at Vacaville. He received a new heart from an unidentified
donor Jan. 3, and has been returned to Vacaville.
A spokeswoman for the medical center said the cost of the procedure
was $150,000 to $200,000. But that does not include security costs, aftercare
or post-transplant medication that can run as much as $21,000 per year.
Department of Corrections officials have estimated that total costs
could reach $1 million before the inmate is released. After his release,
he will have to seek private insurance or qualify for government-run medical
coverage such as Medi-Cal.
Faced with a prison population that is growing, aging and plagued with
communicable diseases such as AIDS and hepatitis C, California's medical
bill for its 160,000 inmates has swelled in recent years.
The department will spend an estimated $663 million in the current budget
year for medical treatment, an 11 percent increase over the previous year.
Like most government agencies, the department does not have medical insurance
because premiums would be prohibitively expensive and comprehensive policies
difficult to obtain.
In the case of organ transplants, cost is not the only issue. A paucity
of donated livers, hearts, kidneys and lungs means thousands of people
who need a new organ die each year while waiting.
As of Wednesday, according to United Network for Organ Sharing (UNOS),
the nonprofit group that manages national transplant waiting lists for
the federal government, there were 4,139 people waiting for new hearts
nationally, 549 of those in California and six in the Sacramento region.
"We're essentially giving a heart to an inmate when there are other
people out there, potentially more productive members of society, who are
in line as well," said the Department of Corrections' Heimerich. "It's
a tough problem."
In 1976, the U.S. Supreme Court held that "deliberate indifference"
to a prison inmate's health problems constituted cruel and unusual punishment
and thus violated the Eighth Amendment of 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.
Last April, the governor's office reported there were more than 700
individual lawsuits pending by prison inmates over medical care issues.
The state paid out $2 million to settle prison-medical care lawsuits
in the fiscal year that ended in June, including $350,000 to a female inmate
who claimed a prison doctor for years ignored signs she had breast cancer.
"Medical care is probably the biggest cause for (inmates) bringing suits
against the states, because they are not providing adequate medical care,"
said Kara Gotsch, an attorney with the American Civil Liberties Union's
National Prison Project. "Certainly costs are going to rise as the population
ages and medical procedures become more expensive ... but prisoners have
a constitutional right to medical care. It's as simple as that."
Similarly, prison inmates are not discriminated against when it comes
to deciding who gets what organ.
"Whether someone is in jail is not going to enter directly into consideration,"
said Anne Paschke, a spokeswoman for the United Network for Organ Sharing.
"It could enter into consideration indirectly when it comes to criteria
like their history of following doctors' orders, drug and alcohol use and
so on, things that many prison inmates might have trouble meeting. But
just being in prison doesn't disqualify someone."
Under the network's procedure, a patient diagnosed by a transplant center
as needing an organ is placed on a waiting list.
When an organ becomes available, the information about it, such as the
age and gender of the donor, is entered into the computer.
Those on the waiting list who are not a good match are dropped from
consideration for that organ, and the rest are ranked according to a number
of factors such as immediacy of need, geography and likelihood of the transplantation's
Some states have attempted to avoid the issue by simply releasing very
"What they do is trigger early release or compassionate release to get
the inmate out of the system," said Scott Chavez, vice president of the
National Commission on Correctional Health Care, a not-for-profit organization
of medical providers that focuses on better health care in prisons, jails
and juvenile detention centers. "That way they avoid having to do the transplantation
and having to pay for it."
But Heimerich said early release was never a consideration in the case
of the heart patient at Vacaville. "Compassionate release" is generally
granted in California, he said, only when the prisoner has less than six
months to live but is not in imminent danger of dying.
In this case, the inmate's condition was critical when he received the
Statistics show that heart transplant recipients in the inmate's age
range have a 70 percent chance of living at least five additional years.
"The judge did not sentence this guy to death," said Heimerich, "and
who knows? He may get out and become a productive citizen."
About the Writer
The Bee's Steve Wiegand can be reached at (916) 321-1076 or email@example.com
Here is my letter to 60 minutes. Sorry it took so long to do. I appreciate
your constant reminders! I posted it here at this website:
Dear 60 Minutes,
I have watched your program for at least 30 years.There have been times
when you so wanted to make a statement that you were blind to the whole
picture. Your story about giving a prisoner a heart transplant is a case
Of course, giving a heart transplant to a prisoner is pretty radical
especially since the aftercare may be inadequate at best, non-existent
at worse. It seems like aftercare should have been one of the categories
considered by the review panel that chose this inmate for a transplant.
This was really an extravagant decision especially since it involved public
money, but then officials make other extravagant decisions with the public
treasury like saving beached whales, or spending obscene amounts on officialís
salaries like the $300,000+ a year recently awarded to the CEO of LAís
Department of Water and Power.
What the transplant story covered up by its notoriety was the poor medical
and dental care inmates currently receive in our jails,detention centers
and prisons.My son, an inmate in a California state prison has been waiting
for a dental appointment for four years to replace the temporary filling
he received when he was first imprisoned. He tells me that the common
practice in his prison is extraction, not cleaning or filling, so an appointment
may not serve his needs after all.
Not only is care minimal but the attitude about providing care is blatantly
non-professional. A cell
mate of my son went into a diabetic coma in their cell and it took
15 minutes of calling by him and others to get a correctional officer to
take emergency action to save the manís life. These are two examples
that I know of first hand. There are tens of thousands of cases, many resulting
in the death of the prisoner because of lack of access to medical care.
Your story while demonstrating outrage over one incident effectively
covered up the greater story of
systemic abuse of incarcerated individuals. You owe it to your reputation
to be more discerning in your reporting.
This is an excellent example of the message we need to also deliver
to the Sacramento Bee - firstname.lastname@example.org
. Thank you so much for writing it and for all the hard work you
people every day.
email@example.com is the address to respond to this horrible editorial
before we see some publicity seeking legislator proposethat inmates should
be denied all transplants and feeding frenzy begins. I have responded to
points in bold italics to give you ideas.
Editorial: Transplant travesty
Inmate gets new heart while others wait?
Bee Editorial Staff
Published 2:15 a.m. PST Monday, December 30, 2002
The recent death of an armed robber who received a heart transplant
while serving a 14-year prison sentence in California has stirred up a
hot ethical debate, and rightfully so.Why should a convicted felon serving
time for a violent crime get a heart while law-abiding citizens who suffer
from heart disease cannot?
Because the public did not allow this man to be sentenced to death.
There is a passage in the Bible that tells me this editorialist cannot
possibly be a Christian. Christ said,. "Whatever
you have done to the least of you, you have also done it to me."
That means that in God's eyes all people have equal value. Christianity
is based uon this concept.
Christ was a felon. He hung between two robbers and forgave them
for their mistakes. He made it very clear that everyone is to visit the
sick in hospitals and prisoners, to care about them, and yet in California,
citizens are prohibited from doing their duty as Christians.
The Hippocratic oath commands that all human lives are of equal importance.
State murder by medical neglect is still murder . Another Christian commandment
is that killing is wrong, no matter who does it. Some 80% of Californians
oppose the Death Penalty, they do not want to see state murder by medical
The short answer is that he should not.
That is a holier-than-thou judgement which is incorrect. If we as
a people are going to cage people in conditions worse than animals, we
have an obligation to care for them. The stresses in prison and injustice
in the criminal justice system most likely greatly worsened his condition.
We have no business caging up medically ill people who should be in healing
environments, but such is the case. If you cage a dog, it is your responsibility
to care for it. We oppose medically ill people being placed in an environment
of disease and violence where the weak cannot survive. This was the first
and most important moral violation in this entire situation.
The Legislature should make sure it doesn't happen again.
Wrong. The legislature should stop wasting so much money on nonsense
and increase medical care for prisoners. It is not only the right thing
to do, it saves millions in lawsuits filed by victimized families who value
their loved ones as much as you value yours. What makes you think your
loved one couldn't be in the wrong place at the wrong time and caught up
in the jaws of our awful prison machine? You'd be thinking much differently
with that little dose of reality. If we can waste billions on a human bondage
industry that does more to cause crime than to cure it, we can provide
medical treatment to the "livestock" slave labor that fuels the biggest
industry in California.
At the time the 32-year-old convict received his new heart, 4,119 other
patients were on a waiting list for heart transplants. It's a pretty safe
bet that none of the others on that list were serving time in prison for
armed robbery.As Department of Corrections officials see it, a 1976 U.S.
Supreme Court ruling compelled the state to pay for the transplant. That's
not exactly true.
You have no idea how many people are impacted with a loved one in
prison, even those on the waiting list. Writing on the basis of bets is
risky. Especially considering the numbers of Californians touched by the
huge prison industry.
The court said that deliberate indifference to serious medical needs
violates the U.S. Constitution's 8th Amendment prohibition against cruel
and unusual punishment. Does avoiding "deliberate indifference" translate
into an affirmative obligation to provide heart transplants?
Yes it does. Whenever we have the technology to provide medical and
dental care and it is denied because of cost, that is the same as murder
by medical neglect. He didn't have a death sentence, and how do you know
that he was even guilty in the first place? Maybe his family was starving
and he made a desperate mistake. He obviously was not a repeat offender
or he'd be under the Strikes law for life.
Should this have resulted in a death sentence? You have no right
to judge anyone this harshly, especially with the amount of corruption
that exists in our non-system. You can't be much of a journalist if you're
not aware that the justice system is completely broken.
That seems to be a tortured interpretation of the court's opinion, at
best. It's unlikely any court would require the state to pay for an incarcerated
felon's heart transplant.
Interesting that you would use the word "tortured" because this is
happening daily in California's prisons. The law calls for a "regular standard
of community care." You are ADVOCATING a change in this law and showing
your own callousness and prejudice against tens of thousands of Californians
and US Citizens. You ADVOCATE letting people die because the horrible environment
of prison is full of disease and you think this would save money. You are
as bad, if not worse, than any mentally ill prisoner incarcerated to even
suggest that murder by medical neglect is acceptable. You are a disgrace
to the profession of journalism to ADVOCATE such an evil concept.
Do you not realize that millions of your readers are connected to
Maybe we should give you a wake up a call. How about if all 6000
mothers, fathers, wives, husbands, sisters, brothers, aunts, uncles gave
your publisher and your advertisers a call expressing outrage at this ridiculous
excuse for an article? How would you like to see us picketing beneath your
window. Get out of your cubicle and see what's going on in the real world.
You deserve to be put in a stockade in the public square for putting this
hateful piece in the newspaper. Have you forgotten that the original founders
of America were all prisoners?
It becomes even more unlikely if other individuals who haven't committed
crimes and are also desperately in need of transplants have to wait in
line behind the inmate. Stanford University Hospital, which performed the
surgery, said the inmate "was evaluated for transplantation under the same
criteria applied to all transplant candidates, including medical evaluation,
psychosocial assessment and education." Amazingly, the fact that the patient
was serving time in prison for
armed robber was not part of the equation.
That's only amazing to someone who considers themselves of more value
than others. In the medical profession, they do not consider anything but
the best match, which is the way it should be.....and as a journalist,
you should realize that you, yourself are vulnerable to a prison sentence.
That is if you were ADVOCATING for the good of people instead of brown
nosing the State, which will keep you free and out of harm's way. But it
fails your calling and violates human rights laws and ethics. Your article
is a disgrace.
Before the inmate died, his transplant surgery and after-care cost amounted
to close to $1 million.
The state wastes that much money on potholes. People are more important
Without the state footing the bill, a homeless person or an uninsured
law-abiding single parent would have a hard time getting an appointment
to see a doctor to be evaluated for a new heart, much less get it.
Duh! Many homeless people are parolees with no place to go. And many
prisoners are foster children who were neglected and abused in the system.
Are you only prejudiced against people when they're behind the bars or
after they're mistreated and thrown out on the street and become the "homeless"
you are willing to defend.
Ben Rich, an attorney and bioethicist with the University of California
Medical Center, Davis, argues sensibly that the state has neither a moral
nor a legal obligation to provide a prisoner with a new heart.
Attorney and ethicist are an oxymoron. Inmates must be
"provided with a minimally sufficient level of care," Rich says, but a
heart transplant goes well beyond that.
If Rich said that, it would be more appropriate to question why he
calls himself a lawyer and doesn't know the law. "a regular standard of
community care is the law." Did the two of you come up with this article
together? It is well-known that UC Davis has thousands of families of prison
guards employed and maybe they need to be boycotted and cut off from funding
as well. Families of prisoners are in high places too, including the clergy
and funding sources. Do you realize how destructive the prison machine
has become during the last decade? You are about to find out with an angry
For a new heart, Rich says prisoners should have "to draw on their own
resources or the charity of others, just the way the homeless person on
the street who has not committed a criminal offense would have to."
Prisoners and their families have almost no resources after the State
and courts grind them into hamburger meat.
Because the state will pay for it, a violent felon serving time in prison
can get a new heart.
There are thousands on inmates needing transplants and their families
will file millions in lawsuits if their loved ones are allowed to die from
medical neglect There will be no cost savings.
Because the state will not pay, a poor law-abiding productive member
of society most likely will not. The world is full of absurd situations,
but you would have to look long and hard to find another that turns morality
and legality so sorely on their heads.
Morally, if you'd be willing, I'd like to send you a copy of the
law and the Bible, although I must admit that meeting any prisoner, even
the criminally insane, would be preferable than meeting someone who advocates
murder by medical neglect. May God have mercy on your wretched soul and
may your publisher put you in a quiet job in the mailroom.
I hope this has inspired you because silence is deadly.
The editorial you published Transplant travesty Inmate gets new heart
while others wait? Published on December 30, 2002 exposed a callous attitude
toward people's loved ones in prison.
The inmate was not sentenced to a death sentence. He was sentenced
to 14 years for a crime he may have committed out of desperation.
Most burglaries happen because of poverty.
But for you as a journalist, supposedly, to advocate State murder by
medical neglect is just wrong. And murder in California is punishable
with a life sentence without parole, even when it is in self defense and
even when you were just the driver, not the triggerman.
Murder by medical neglect is a crime against humanity and puts YOU far
beneath the inmate who may have robbed out of desperation. I thought
journalists were supposed to defend the rights of the people? The
Bee appears to be defending the monsters in charge who have bankrupted
our state by making the human bondage industry California's number one
source of revenue.
It is basic that when we take away something as precious as a person's
freedom, we take care of all their medical and emotional needs. Otherwise
they return to their communities much sicker than before they were incarcerated
which endangers the public safety. None of the murder and suffering
caused by medical neglect is saving California taxpayers any money.
Far from it when the families have no choice but to file lawsuit over abuse
and neglect, the cruelest form of torture.
Shame on you for advocating murder by medical neglect to save money
when the guards just received a 37% raise. I was so upset that I
called a few of your advertisers who have inmates inside. Don't you
realize that about 3 million
Californians are devastated by the dysfunction of the criminal injustice
and are connected by blood to a prisoner?
Everyone thinks it can't happen to their loved ones until it is too
There is so much love in this letter by Sidney.
Dear Cayenne: Copy of letter to OPINION@SACBEE.COM
RE: Transplants for Inmates
I would not want full responsible for choosing who gets transplant opportunities
but I certainly would not want the weight of denying ANYONE transplant
opportunies due race, creed, color, housing status, finanical status, voter,
non voter, inmate, ex con, stature in society, choice of faith, church,
Our creator gave us our heart....what we do with it should be judged
by him. There are millions outside the walls who may not "deserve"
a transplanted heart if society knew what skeletons they have tucked away,
(a figure of speech.)
Are only those who are behinds walls guilty of crimes? Are all
behind bars guilty?
If we stop trying to assume the role of the "Almighty," which
we can never replicate, we might try looking at the gift of the "spirit"
that goes with the heart. Who knows what is in store for the recipient
and what great things one might do with it regardless of his/her past.
Oh how could this turn a life around...what great example of rehabilitation.
What of insurance fraud? Not legal but does it exist? Who
takes responsiblity for bumping someone up or down a list because of a
healthy deposit or donation if you will?
Have a heart....I have seen a man in near need of a transplant and I
personally had great fear of him for many years. Yet when I saw him
undergo bypass surgery on the "Widow Maker" as it was formerly called
for a 98 percent blockage, I would have traded places to give him a chance
to turn that around. He did not need that chance, he survived the
surgery to continue instilling fear and pain in my life for several more
years. The state paid for that surgery because he was unable to work
and eventually lost his insurance - no job- no premium payment. I
guess my point is..just because it is publicized in such a fashion, the
law to deny inmate transplants will most likely pass. On the flip
side of the coin, it is what goes on silently that gets by without a glance.
I wonder if the prison industry could bill for two inmates if one had
such a transplant, would there be any conflict then?
"..the Department of Corrections has "been underfunded for a long
This is putting it mildly! Please help come to our rescue. Society needs
to know how their tax dollars are being spent and housing mentally ill
and non violent prisoners is not the way I want my tax dollars spent. Shorten
prison terms and get these people rehabilitated and back to society to
support themselves. Sitting twiddling their thumbs while guards sit in
towers and behind locked doors earning high pay plus overtime is not helping
our societal issues of crime and criminals in the least. The keyword is
We need help to get these human beings education, medical treatment
and total assistance for the mentally ill who were thrown to the winds
when released from mental hospitals and now live in the streets committing
crimes just to be able to eat. Our prisons are not meant to house the mentally
ill. Human beings die frequently due to lack of medical treatment in a
timely manner. How are people with no teeth going to become employed when
they leave prison.
What type of business would give a toothless applicant a chance at a
job. Yet dental work is almost non existent in our prisons where young
people are sitting out their sentences. Too bad you say, yet that is inhumane
to say the least and ..... Do we want to support them forever? Our system
is set up to do just that. How can we expect the drug addicts to get drug
free and return to society clean when drugs are supplied to them while
incarcerated by the prison guards themselves? I call that job security!
The revolving door assures some jobs without worry.
Our system needs revamping. We need a completely different philosophy
on dealing with people sent to prison by the courts. What is truly best
for society? Certainly not spending our tax dollars on punishment for twenty,
forty or one hundred years! The punishment time should be short and the
rehabilitation time longer. Help to change thinking, ability to think and
education are the answers. Housing of the mentally ill is not a prison
function, yet a large number of them are being housed there because the
court system nor the prison system seem to know what to do with them.
Our society needs educating and help to understand how our money is
actually being spent. I am betting there would be a lot of sleepless nights
if the Christians in our society knew what they were supporting. I know
you are not allowed inside the prison to actually talk freely with prisoners
even if they are willing to talk. What about our freedom of press to print
the truth, the whole truth? That does not count with prisoners. The truth
might get out. We must depend on you to dig for the information in bits
and pieces to present the rest of the story.
But now we talk instead of budget cuts and prisons again are targeted.
We cannot properly feed the human beings in prisons now, and to cut budgets
would be even more inhumane. Certainly they will NOT cut guards pay checks,
or numbers of guards, or overtime without further cuts on the prisoners
Thank you again for the message that you have gotten out to the public.
Hopefully you will hear from more of us on the subject.
This is another sample letter similar to the one you wrote to the Bee
which you should send objecting to their recent show that left the impression
that California inmates get excellent medical care. About 200 letters ought
to get their attention and we hope they cover our event where families
who suffer with medical neglect of their loved ones can be interviewed
From: Bob Driscoll
Subject: Prison Health Care
The unique case of a man receiving a heart transplant in California
left the impression that inmates were receiving the best medical care available.
This is so far from the truth that it seems not much research was done
to find out just how barbaric conditions are in the prisons.
California was forced into some care by a lawsuit that showed the total
lack of care. The fact remains that since the media are excluded by law
in California from examining these hell holes the real story is hidden.
Recently a man died of a bladder infection because the guards, on overtime,
refused to let him see a doctor during one of the many lock-downs that
occur constantly. He had a history of this problem that was known to everyone.
This is one of many such needless deaths.
HIV is rampant, Hepatitis C is pandemic. Decent care is non-existant.
Women prisons are worse than mens'. California doesn't even give a physical
to know what the new inmate's condition is. Then if they get out >they
are sicker than when they went in and spread to the civilian population.
Getting to treatment isn't the only problem. How does one stay healthy
on a diet of $2.45 per day? Without the families sending whatever they
can in to keep their loved ones alive, death from starvation and diseases
caused by malnutrition would be more rampant.
The story does set up the prisons for massive budget cuts that the public
will think justified because of your distorted piece.
here for letters to 60 Minutes
It occurs to me that there is a fundamental lack of understanding about
the state incarcerating people. The Court sentence is THE PUNISHMENT,
ie; loss of freedom. These human beings are not sent to prisonTO
BE PUNISHED, like in a Gulag or a dungeon. The person becomes a ward of
the state hence the name "warden" running the prison. The state assumes/takes
responsibility for all, care including medical.
In recent years inmates had to sue the California Department of Corrections
(CDC) to get even MINIMAL care which if provided might reduce the 50 inmates
dying under their supervision each month. Now due the court order to provide
care and the politization of the implant process one lone inmate gets a
heart and the emotional response is to pass another law to inflict more
harm to another human inmate by passing a law preventing transplants.
Will this law also prevent the state from harvesting the organs of the
inmates you have sentenced to death?
When my wife passed away 5 years ago it was a very difficult time for
me. She had just given birth to our son 12 day before and we had 5 children
ages 18, 16, 8, 2 and 12 days. She died of a brain aneurysm. We donated
her organs in the belief that is was the right thing to do and were not
told, NOR DID WE CARE who received the organ. Life is life no matter who's
it is! I now have a girlfriend, A very beautiful and wonderful person that
I love very much as do my children.
She is serving a 50-year to life sentence at Valley State Prison for
women in Chowchilla California under California's draconian three strikes
law. She has never had a violent past and her only problem was her drug
addiction. Her prior strikes occurred 10 years prior when she was 22 for
being a look out for a boyfriend that broke in to 3 houses side by side.
Thus 3 strikes. 10 years later she was caught with 1.26 grams of meth and
was sent to prison for life. Now I would give my own organs to anyone that
It's just the right thing to do. To question who receives the organs
is discriminatory and is against the Hippocratic oath every doctor takes.
Senator Denham is trying to introduce a bill that would ban prison inmates
from receiving a transplant. It should not matter who receives a donor
organ. Every life is precious! We should take a good look at why we incarcerate
non-violent drug offenders for life.
It is fiscally irresponsible and also the wrong approach in dealing
with drug offenders. Prop 36 passed by the voters has had an 80% success
rate and is the will of the people. But was never made retroactive so we
still incarcerate 40,000 people for petty drug charges. At 27,000 dollars
per inmate each year, just do the math and you may see where the state
can really save and serve the will of the voters. Gray Davis won't touch
the prison budget because the CCPOA gave him 2.5 million dollars for his
campaign. Please help to bring California's criminal justice system back
to one that is not corrupt and driven by greed. And remember that a human
being no matter where they are, are still human beings. Very sincerely
Francis Courser, Escondido, Ca.
When you wrote that obnoxious editorial which called for a law to deny
transplants to inmates, I wondered if you ever considered that most inmates
are very willing to donate their organs to others when they die.
I haven't ever seen any statistics on it, but I'd be willing to be that
many an inmate has donated organs.
Obviously you don't understand that inmates are us.
They are wives, husbands, cousins, sons, daughters, grandparents of
millions of Californians connected to them who love them very much.
The prisons are full of the mentally ill, frail elderly, and others
who have fallen through the cracks. A transplant cost $500,000 not
a million, but how can you put a dollar value on anyone's life?
This man was not sentenced to death, yet with the violence and disease
in our horribly mismanaged prisons, any sentence to prison is a potential
I was really disappointed to see you invalidate the feelings of some
many people who worry about their loved ones in prison. Pretty hard-hearted
in my opinion, makes me want to cancel my subscription, call your
advertisers, alert others to do the same, that's how deeply the piece cut
Did it occur to you that the freak awarding of a heart transplant to
a prisoner was intended to create the very backlash your editorial is participating
in? Medical care in our 33 prisons is abysmal; thatís why our courts ordered
CDC to change for the better. Now, no one likes to be ordered by any court
to do anything, especially something difficult and costly. Seems to me
that initiating a big furor over a heart transplant, instead of knuckling
down and improving the system--so medical records are kept on CDC-wide
computers instead of 3 x 5 cards, requests to see a doctor donít take over
two weeks to be honored, and prescribed medicines reach a patient with
some semblance of regularity--might just have been a purposeful tactic.
Deborah D. J.
January 20, 2003
The inmate who received a heart transplant while
serving a prison sentence in California has indeed stirred up a hot ethical
debate. And the answer you in your misguided editorial was that it
was wrong for this to have happened and it was the duty of the Legislature
to make sure it never happened again.
Excuse me? When does an editorial board take
it upon itself to decide who lives and dies? And why would you even
want to go there?
The Hippocratic oath commands that all human lives
are of equal importance.
In God's eyes all people have equal value.
Christ was judged a felon. He died an agonizing
death hung between two robbers. And even as He left this world, He forgave
them for their sins and He forgave others as well, for they knew not.
Mary Charlotte White
Bill aims to limit organs to prisoners
The debate over a heart transplant spurs the effort to let donors choose.
By Ed Fletcher -- Bee Capitol Bureau - (Published January 24, 2003)
Just over a year ago, a California prison inmate received a heart transplant
while incarcerated -- an event believed to be the first of its kind in
With thousands of people waiting for organs, the operation and follow-up
care -- costing more than $1 million -- generated outrage.
State Sen. Jeff Denham, R-Salinas, is turning that outrage into legislation.
Convinced that the incident may have discouraged would-be donors, the
freshman senator has introduced SB 38. The bill would let would-be organ
donors check a box indicating their desire to prohibit their donation from
going to a person incarcerated in a state prison or a county jail.
"People are outraged that organs are going to inmates," Denham said.
Denham has extra motivation to care about the supply of organs for transplantation.
His father, John, died in November at age 54 while waiting for a liver
"We have over 80,000 people on donor lists and people ripping up their
donor cards," said Denham. "Had there been more organs available, my father
would be alive."
A 32-year-old prisoner's heart transplant in January 2002 is at the
center of the controversy.
The unidentified man, serving 14 years for two counts of second-degree
robbery, died last month after his body rejected the heart.
The man is one of only two inmates who have received organs since 1996,
said Margot Bach, a spokeswoman for the Department of Corrections. The
other inmate received a liver transplant.
She said allowing the heart transplant was not the department's call.
"The U.S. Supreme Court requires us to supply community-level health
care," Bach said. "We had no choice. It was not our decision to make."
Had the state blocked the operation, the prisoner would have died sooner
and the state would likely be facing a lawsuit, Bach said. She said she
thinks the state would have lost such a suit.
The need for more organ donation is clear. As of late Wednesday, more
than 80,000 people nationwide were waiting for organs.
It is unclear, however, whether anger over inmate transplants is discouraging
Mary Wallace, a spokeswoman for the California Transplant Donor Network,
said the nonprofit agency received about 10 calls from people upset that
organs are going to prisoners, but she said it got 10 times as many calls
supporting the current donation system.
"The confidentiality and objectivity of the transplant system make sure
the sickest patients receive the organs the fastest -- not the richest,
not the smartest, not the most socially acceptable. The person with the
greatest need gets the organ first," she said.
The current system tells agencies such as the California Transplant
Donor Network next to nothing about the recipient.
"All we know is their sex, their size and that they need an organ,"
Wallace said. In the much-debated case, she said, officials didn't know
they had placed an organ with an inmate until after the fact.
Bioethicists and other scholars railed against the idea.
"The statement that someone should not get (an organ) because they are
not worthy is very disturbing. Because that puts value on one life compared
to another, and we don't have a 'God Squad' to do that," said Guy Micco,
director of the Center for Medicine, the Humanities and Law at the University
of California, Berkeley.
Lawrence Schneiderman, a University of California, San Diego, researcher,
warned of the "slippery slope" created by allowing some people to be excluded
from medical care. He predicted such a law would not withstand a test of
"I think the U.S. Supreme Court would just shoot this down. They have
already said that you have to give them access to health care (or) it is
cruel and unusual punishment," Schneiderman said.
Senate President Pro Tem John Burton indicated this week that the bill
wouldn't have a smooth ride in the Legislature.
Burton, D-San Francisco, said he wonders who might be the next group
proposed for exclusion. "I guess I should have a right to say I don't want
my organ to go to a right-wing Republican," he said.
Over his 11 years as a Butte County prosecutor, Shawn Stinson has sent,
by his estimate, more than 1,000 people to jail. But should an organ fail,
an inmate should have the same right to an organ as he himself does, said
Stinson, a Chico resident waiting since April 2001 for a liver.
"I think inmates don't forfeit the right to life, liberty and the pursuit
of happiness," Stinson said. "If we start to discriminate, where does it
The Bee's Ed Fletcher can be reached at (916) 326-5548 or firstname.lastname@example.org
See Response to Senator
Dunham's Transplant Bill
Donating Organs to Inmates Targeted
A state senator whose father died awaiting a liver transplant wants
donors to be able to opt out of letting their body parts go to prisoners.
By Jenifer Warren
Times Staff Writer
January 24 2003
SACRAMENTO -- Outraged that a prisoner received a taxpayer-funded heart
transplant and later died, a state senator wants to give Californians the
option of designating that their donated organs not go to patients behind
Republican Sen. Jeff Denham, whose father died in November while waiting
for a liver transplant, believes people have grown less willing to donate
organs because they fear their body parts will wind up helping a convict.
"Donors want to know that their organs are going to save a sick child
or productive member of our community," said Denham, a freshman legislator
from Salinas. Prisoners, he believes, should not enjoy the same right to
donated organs as ill Californians who are not incarcerated.
Denham's bill, SB 38, has yet to receive any legislative scrutiny. But
officials with at least one federally designated organ procurement organization
are strongly opposed, saying the measure's intent violates the objective
standards guiding who gets transplants in the United States.
"The organ allocation system is based solely on medical and scientific
criteria ó not on which patient is the richest, the smartest or the most
socially acceptable," said Mary Wallace, spokeswoman for the California
Transplant Donor Network.
Creating subjective standards for deciding who gets organs, she warned,
would threaten the equitable nature of the process and "lead us down a
very slippery slope."
Senate leader John Burton (D-San Francisco) summed up his concerns this
way: "Where do you draw the line? If it's prisoners today, it might be
people over 70 tomorrow, or blacks, or Jews or Catholics."
Burton added that although many Californians "would not want Charlie
Manson to get a transplant, they might feel differently about a 19-year-old
kid in [prison] for petty theft with a prior."
Despite such skepticism, Denham's bill reflects a burst of public anger
that followed the inmate's state-funded transplant a year ago. The senator
said he had reports of some Californians tearing up their organ donor cards
in disgust, and Wallace confirmed that officials at the transplant network
had received calls from some who were taking that step.
The unidentified inmate ó the first California convict to get a new
heart and only the second given a transplant of any kind ó was serving
a 14-year sentence for a Los Angeles robbery at the time of his surgery.
Due to be paroled in 2008, he was suffering from a viral infection that
led to a gradual degeneration of his heart muscle.
After he was struck with congestive heart failure, the inmate was taken
to Stanford University Medical Center, where he was kept alive by a machine
that made his heart keep pumping. Hospital officials determined that a
transplant was medically necessary, and a Stanford ethics committee approved
him for the surgery.
The patient had done fairly well after the transplant and was taking
anti-rejection drugs, prison officials said. But by fall, he was ailing
and it appeared his body was rejecting the organ. A corrections spokesman
said he "was not a model patient," suggesting he may not have been taking
his post-surgery medication as directed.
The prisoner died Dec. 16 at Stanford, and corrections officials estimated
the costs of his transplant and related care at$2 million, including $1
million for the surgery and $12,500 a day for his stay in the intensive
Officials said they were compelled to provide the transplant by court
decisions concluding that denial of decent medical care to prisoners amounts
to unconstitutional cruel and unusual punishment.
Denham called the inmate's transplant outrageous, saying that taxpayers
should not be forced to foot the bill for such expensive procedures for
prisoners. His bill, however, is more narrowly drawn. It would simply allow
motorists who fill out forms donating their organs or tissues to specify
that no incarcerated person may benefit.
The senator said he was motivated in part by a personal experience ó
the death of his father, John, in November at age 54. John Denham suffered
from hepatitis C and was on a waiting list for a new liver for about a
year, his son said.
"I want to make sure there are more organs available so people won't
lose someone like I did," Denham said. "We can't afford to have people
tearing up their donor cards because they think a prisoner will benefit."
Nationwide, about 80,000 people are on waiting lists for life-saving
organ transplants. Wallace, of the transplant network, said very few of
them are prisoners, although she could not provide precise figures because
such lists are confidential.
Because of the organ shortage, a transplant candidate dies every 90
minutes in the United States ó a total of 6,124 in 2001. Among people who
die under conditions that make them medically suitable to donate their
organs, about one-third do so, Wallace said.
Denham said he hopes his bill will encourage more Californians to become
But one medical ethicist called his approach inappropriate and warned
against altering health policy in a piecemeal fashion.
"If we want to ration health care, we need to have a reasoned debate
about it and decide, globally, who gets it and who doesn't," said David
Goldstein, co-director of USC's Pacific Center for Health Policy and Ethics.
"Until we do that, we shouldn't take potshots at this person or that
person. This is just emotional flailing by someone who happens to have
a bully pulpit."
If Denham's bill became law, it would not be the first time a high-profile
transplant had led to changes in organ donation. In 1996, the United Network
for Organ Sharing declared that people suffering from long-term liver failure
typical in alcoholics and drug addicts would no longer be at the top of
the list for liver transplants.
That change came after Mickey Mantle and former "Dallas" star Larry
Hagman received liver transplants.
Inmates should continue to be considered for transplants in the
future as was the case with the inmate who received the heart transplant.
Most inmates will one day get out of prison. If they are excluded
from this list of people who are in need of transplants while they are
in prison will they then be allowed on the list when they get out?
Or will the next exclusion be those who were once inmates? And from
there where does it go?
Those who over eat, those who have abused substances in the past or
maybe even those who jog down the road because they can potentially be
hit by a car thus wasting an organ for someone who adheres to less risky
behavior? I applaud California for taking the step in the right direction
and allowing this transplant to take place despite the final outcome.
I hope that the legislature will think twice before passing Senate Bill
38 which would exclude prisoners from the transplant list. Passage
of this bill will only set precedent for future excludees.