Category Archives: Regulations

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?

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‘Kidneyville’ and other tales from the global organ trade

In this NPR segment, journalist and author Scott Carney describes a disturbing but lucrative international trade in human blood, bones and organs. The piece is a couple of years old, but well worth a listen.

Buying and selling organs is illegal almost everywhere, but Carney, who wrote a book on the subject, discovered a thriving black market for human body parts:

As part of his research, Carney visited an Indian refugee camp for survivors of 2004’s massive tsunami. Today, the camp is known by the nickname Kidneyvakkam, or Kidneyville, because of how common it is for the women who live there to sell their kidneys.

“The women are just lined up,” Carney says. “They have their exposed midriffs and there are all these kidney extraction scars because when the tsunami happened, all these organ brokers came in and realized there were a lot of people in very desperate situations and they could turn a lot of quick cash by just convincing people to sell their kidneys.”

Trafficking in human tissue raises many ethical questions, but Carney says one of the most disturbing aspects of the trade is that organs are almost always taken from a poor person to benefit someone richer.

His book, The Red Market, is available here.

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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Meet the (many) regulators

Logos of some of the agencies that oversee organ and tissue donation in the U.S.

Logos of some of the agencies that oversee organ and tissue donation in the U.S.

The rules and policies surrounding organ and tissue transplants in the United States are governed by an alphabet soup of state, federal and private entities.

Called “anatomical gifts” in legal parlance, organ donations have been nationally regulated to some extent since 1968. Prior to that, transplants were monitored by local agencies in each state. Modern federal laws now govern donor qualifications, set rules for organ distribution and ban the sale of organsEach state also still has its own set of rules. (Click here for a database.) 

Perhaps the easiest way to understand transplant regulation is to start with who isn’t involved. The Centers for Disease Control has no authority over donations and transplants. The Food and Drug Administration also has little to do with organ donations, although it does oversee screening for tissue, bone and muscle donations.

Organ transplants are broadly regulated by the Health Resources and Services Administration, which is part of the department of Health and Human Services. The practicalities of collecting and transporting organs is the responsibility of the United Network for Organ Sharing and the Organ Procurement and Transplantation Network.

Both networks also maintain information about the number of patients waiting for organs and often work with the many private agencies that recruit potential donors.