Category Archives: Policy

Inmates, organ transplants and ethics

Members of a chain gang get to work. Source: Wikimedia Commons.

Should prisoners be allowed to volunteer as organ donors? Lawmakers in Utah decided recently that the answer is yes, but the issue remains controversial — especially when it involves inmates on death row.

This story from NBC News provides a pretty good overview of the issue, including an interview with an inmate Joanne Ford who is pleased about the new law. Ford sees organ donation as a chance to redeem herself for past mistakes, but not everyone thinks allowing prisoners who die in jail to donate is a good idea:

Whether to accept organs from prisoners has long been a thorny issue. Ethics experts say it pits questions of coercion of a vulnerable population against the desperate need for organs in a country where nearly 118,000 people are waiting for hearts, kidneys, livers and other life-saving transplants, according to the United Network for Organ Sharing. In most states, accepting organs from inmates who die while in custody is permitted only rarely and under strictly controlled circumstances. No state allows donation of organs from executed prisoners.

Now for an even tricker ethical question: Should an inmate on death row be allowed to receive an organ? Horacio Alberto Reyes-Camarena, who’s awaiting execution in Oregon, has been on dialysis years. Last April, prison doctors suggested he be put on the state’s waiting list for a kidney transplant. And, according to this story from ABC News, his access to prison health care could even improve his chances of getting an organ.

A hard decision, for sure. What do you think?

Global news roundup

Organ donation is big news around the world. Here are a few recent stories:

The Scottish parliament is considering a measure that would change the way people declare their donor status. Under the proposal, consent to donate organs would be assumed unless a patient said otherwise. Neighboring countries are considering similar changes: 

Earlier this month North-ern Ireland’s government backed proposals for an opt-out system with the launch of a consultation. The Welsh Government completed its consultation on organ donation last month. It is now proposing to introduce a system of pres-umed consent in 2015.

German prosecutors are investigating allegations that doctors in the eastern city of Leipzig manipulated data to improve their patients’ chances of a transplant. This isn’t the first time this has happened, and health officials are wondering if the entire organ donation system needs an overhaul:

There have been concerns that the scandals could reduce the already modest willingness of Germans to sign up as potential organ donors. It has been estimated that a person dies in Germany every eight hours for lack of a donor organ.

A team of British surgeons performed the first organ transplants in Gaza earlier this month. Their work is the beginning of an ongoing process to train local doctors at the area’s largest hospital, where the staff hopes kidney transplants will reduce the demand for dialysis:

The UK-Gaza link-up began about a year ago after Abdelkader Hammad, a doctor at the Royal Liverpool hospital, was contacted by an anaesthetist at the Shifa, who outlined the difficulties the Gaza hospital was facing with dialysis. The Shifa is forced to rely on generators because of daily power cuts; spare parts for its ageing dialysis machines have been difficult to import …About 500 patients, including 40 children, need dialysis two or three times a week, according to the Shifa.

Congress considers allowing some transplants between HIV-positive patients

The Hill has an interesting story about a proposal to allow doctors to study organ transplants between people with HIV. Federal law has prohibited such procedures since 1988, but a bill before Congress could change that.

Advocates for people with HIV have long lobbied to end a ban on transplanting organs from one infected patient to another. As the Wall Street Journal explained in October:

As HIV patients live longer, they are increasingly receiving organ transplants in the U.S.—but only from uninfected donors. Some transplant surgeons believe that their waiting time would be shortened if they were allowed to accept organs from HIV-infected donors.

The ban dates to a 1988 amendment to the National Organ Transplant Act. At the time, fear about AIDS was high, and little was known about the condition. The law was meant to prevent accidental transmission of HIV to non-infected patients.

The  bill’s sponsors, Sens. Barbara Boxer, a California Democrat, and Rom Coburn, a Republican from Oklahoma, called the current law “outdated,” and said their bill reflects changes in the understanding of HIV and AIDS.

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Weed and the waiting list

Using this -- even with a doctor's permission -- can jeopardize a patient's chances of obtaining a donated organ. Source: WikiMedia Commons.

Using this — even with a doctor’s permission — can jeopardize a patient’s chances of obtaining a donated organ. Source: WikiMedia Commons.

Should patients who use medical marijuana be kicked off the organ transplant waiting list? One New Jersey lawmaker says no. As this story reports, Assemblyman Peter J. Barnes has proposed a bill that would modify a ban on pot users receiving organs.

“If you’re a person who’s prescribed marijuana and you have an illness, it’s authorized, it’s legitimate, you shouldn’t be turned away for a transplant,” Barnes told NJSpotlight.com “Not for the reason of using the drug.”

The bill was inspired by a California man who was denied a liver transplant after using marijuana prescribed by his doctor.

Although more and more states are allowing medical marijuana, pot is still illegal under federal law. It’s also one of the substances transplant candidates are screened for. Most doctors will remove a patient from the waiting list if he or she tests positive for illegal drugs. Substance abuse can reduce the chances of a successful transplant and — because organs are scarce — doctors want to pick recipients with the best odds.

New Jersey isn’t the only place reconsidering its policies when it comes to medical marijuana. One Oregon transplant center relaxed its rules last year.

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How much for that kidney?

Federal law prohibits the sale of organs in the United States, but some public health officials wonder if it’s time to reconsider that prohibition.

The question of compensating organ donors or their families is fraught with ethical and legal debates. This video, produced by the American Enterprise Institute, makes a case for regulated paid donation:

Would you be more likely to donate an organ if you or your family got paid?