State inmate gets new heart

By Steve Wiegand -- Bee Staff Writer
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 success.

Some states have attempted to avoid the issue by simply releasing very ill inmates.

"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 transplant.

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."

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:

 http://www.cbsnews.com/htdocs/feedback/fb_news_form.shtml
 

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 in point. 

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 official’s salaries like the $300,000+ a year recently awarded to the CEO of LA’s 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 man’s 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. 

Marge Driscoll

Dear Marge:

This is an excellent example of the message we need to also deliver to the Sacramento Bee -  [email protected] .  Thank you so much for writing it and for all the hard work you do for
people every day.

Cayenne

 http://www.sacbee.com/content/opinion/story/5748318p-6719667c.html

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 neglect.

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 prisoners? 

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 than money.

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 reader response.

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.
 [email protected]
Write!

 [email protected]

Dear Editor:

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 system
and are connected by blood to a prisoner?

Everyone thinks it can't happen to their loved ones until it is too late...

Susan Randall

Dear Cayenne: Copy of letter to [email protected]

Dear Editor,

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, etc.

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?

Sidney Peterson

"..the Department of Corrections has "been underfunded for a long time."

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 rehabilitated. 

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 themselves. 

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.

Shirley

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 in person. 

To:  [email protected]
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. 

Bob Driscoll

 Click here for letters to 60 Minutes

[email protected]

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? 

Bob Driscoll

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 needed them.
 

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.

Dear Editor:

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 death sentence.

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 me.

Ann Barker
Sacramento, CA

Dear Editor:

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; that’s 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 don’t 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.

Dear Sirs:

    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.

Sincerely,

Mary Charlotte White
Riverside, CA

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 the nation.
 

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 transplant.
 

"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 donations.
 

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 its constitutionality.
 

"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 end?"

The Bee's Ed Fletcher can be reached at (916) 326-5548 or  [email protected] .

See Response to   Senator Dunham's Transplant Bill

 http://www.latimes.com/news/local/la-me-organ24jan24.story

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 bars.

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 — 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 — the first California convict to get a new heart and only the second given a transplant of any kind — 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 care unit.

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 — 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 — 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 organ donors.

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.

Linda C