The quick summary is that the inmate was sentenced to a life term, has now experienced liver failure, apparently by her own admission because of her previous lifestyle (as opposed to some genetic disease, etc.), and has now moved to the front of the liver transplant list, ahead of people who are not incarcerated. The transplant people have determined that she should get the transplant because they do not want to “judge” her lifestyle, but rather just look out for “the patient’s medical needs.” On top of this, the taxpayers of Nebraska get to foot the $500k bill for the procedure.
So… is this right? Should inmates be able to receive organ transplants when they are serving life sentences? Does it matter that her need for the transplant does not stem from any sort of genetic condition, but is the result of her lifestyle (which, incidentally is what landed her in prison in the first place)? Or should incarcerated people be kept off transplant lists?
Incidentally, it is interesting to click the link near the end of the story and see the feedback from many Nebraskans, the vast majority of whom seem to think this is a great injustice.
I’m not sure where I land on this one yet, but wanted to see what the dopers felt. This just felt like Great Debate material.
People who are incarcerated should not be bumped to the beginnign of the list. Nor, however, should they be kept off the list.
The state has an obligation to safeguard the health and well-being of inmates to the best of their ability. This includes, IMHO, transplants. However, the incarceration should not confer special privliges (such as being sent to the head of the line). She should stand her place in line, just like anyone else.
I did not see this factoid anywhere in the above article. In fact it says she has not yet been added to the waiting list at all because she’s too unhealthy currently to recieve a transplant. Did you find that in a different article?
As the article noted, the Supreme Court said all inmates had a constituitional right to equal medical care. So I would think it perfectly fair for her to go on the list in order of medical priority.
I certainbly don’t think she should get some special priority just for bein an inmate. However the linked article made no such claim.
I’m a prison doctor and have been involved in situations like this. The courts have ruled that prisoner status cannot be used to deny or adjust placement on an organ-recipient list. Therefore the transplant teams are forced to consider them on the same basis as non-felons.
Basically the courts around the nation have ruled that prisoners are entitled to the same standard of medical care as a free person. The difference is that with the prisoner, the government pays for it all.
Is it right? I have my opinions. But I don’t voice them at work. And frankly I’m glad I don’t have to make moral judgements about my patients, just do my best for them.
Should inmates be given better care than the indigent?
I’d have no problem with inmates recieving transplants if every * poor * American was given the same standard of care.
An impoverished person without any insurance in Joy’s condition would be given medication, and kept comfortable, but wouldn’t be getting an organ transplant.
Yes, the state has an obligation to look after the inmates, they do not have an obligation to look after the free poor. Inmates are effectively prevented from earning an income or getting health benefits with their job by the state, due to their incarceration. As such, the state has become their ward and must look after them to the best of their ability. The state is not the ward of free people and has no obligation to look after them.
I say fuck 'em!! It is jail for christ sake!! It is SUPPOSED to be bad for you!!! She is in jail for life. Her liver giving out is the natural end to that life. Why should she get a transplant when A She was sentanced to a life term and this is technicaly going to prolong her life and B Even with this transplant she is still going to be in jail and still going to die there. It just seems like a waste of a perfectly good organ to me. Why not let someone who isnt behind bars have a chance at life.
Some people have brought up the point that poor people are in more need of healthcare than inmates are. I totaly agree with that sentiment. I think if people were given the choice of paying for health care in prisons OR giving health care to the needy ,the prisoners would be done for. I would rather dump the $500,000 needed for the operation into soup kitchens and homeless shelters than dumping into a single prisoner who is already nothing but a burden on society.
That’s an interesting point. So, if you are sick you could commit a low grade felony, plead guilty, and then get your transplant. I think that the felon should get the same treatment a person off the street who comes into an emergency room would get. (At least that is my position now, I may reconsider)
Why couldn’t the free person standard be the free poor person? I don’t see why it has to be the free person with insurance.
Yes, but what if the state is in a budget crisis? It’s like a poor father unable to buy the best medical treatment for his child. It strikes me as slightly unfair that prison workers are being laid off in state budget crunches (losing their medical coverage due to inability to pay the premium) when close to half a million dollars is being spent on a person, who admittedly, did this to herself.
It is not the fault of the state that the inmate is incarcerated. It was through his own disregard for the laws of said state that put him where he is, and removed his ability to make a living.
Honestly, most inmates come from poor backgrounds, and on the “outside” would never be able to afford the quality of care that they’ll recieve in prison. As a prostitute, she would have been treated in a hospital to relieve the pain of her illness, and been given drug therapies, but would not have been a candidate for a transplant because she could not afford it.
I agree that we should provide medical care for inmates. They should be given drug treatments, and nursing care, but I honestly can’t see spending such an enormous sum of money on a person who would have never been able to recieve a transplant if she was not in prison.
Sorry, my wording was definitely bad. I was in a hurry to post the OP before leaving work, hoping to see some discussion of the topic and I didn’t take the time to proof what I had written. I did not mean to imply that she was getting preferential treatment because she was in prison, as I didn’t think that was the case. I interpreted the story (and from the local news coverage I think it was suggested) as indicating that if she passed the “testing” she would be allowed to get onto the list and would, at some point, be higher on the list than non-incarcerated people, not because of her incarcerated status, but just as another person awaiting a transplant.
The key points I wondered what everyone thought about were just whether inmates, especially those sentenced to death or sentenced to life sentences, should be allowed to get in line for transplants the same as non-incarcerated individuals and what people thought of the fact that the State will end up footing the bill.
As was noted, if you are a non-incarcerated person and are too poor to afford the procedure, I don’t know that there is an avenue by which you can get the transplant and have the State (or someone else) pick up the tab. In that respect, it seems incarcerated people could actually be getting some kind of preferential treatment.
Anyway, my apologies for not proofreading my OP. Carry on.
I agree with the growing consensus here that prisoners should not get a higher standard of care than the uninsured poor who walk into an emergeny room.
She should be made as comfortable as possible with medication, but her life should not be extended at the cost of those non-murdering prostitutes who are in need of transplants.
Well, it may be a long shot but you know there is always the chance that new eveidence could come to light proving the inmate serving the life sentence is actually innocent. Now, that’s probably not going to happen in this case and it won’t happen very often but it has happened. Wouldn’t it be tragic if we refused medical attention on someone because they were “bad” only to find out that really they were “good” and we messed up?
IAAL, so I certainly understand your point about the possibility of this woman being found innocent someday in the future. That doesn’t do much to respond to the notion that the State would be paying for a transplant where there’ s a good chance that if she was not in prison she would not be able to afford it herself. For example, if I needed a liver transplant right now I doubt I could afford it unless my insurance covered it. (just a guess, but she likely didn’t have insurance during her prostitution days) So… if the State ultimately does pay for her to get a transplant, does that set a precedent that people who are in need of transplants but can’t afford them should go out and commit some sort of crime so that they can get the transplant on the State’s dime?
So I think there’s two issues here:
First, most people seem to be of the consensus that a person who is in prison should be entitled to the same health care as a person not in prison. No preferential treatment, but also no discrimination against the person just because they’re in prison.
Second, most people also seem to be of the consensus that the State should not pick up a $500,000 tab to pay for a procedure taht many non-incarcerated individuals might be eligible for but cannot afford.
Just to fuel the discussion a little more, of what import is the fact that the woman who is in prison is basically in a position where she can’t make money right now to pay for a procedure like this, can’t save money right now to pay for a procedure like this, can’t likely get approved for some kind of loan or financial assistance to pay for a procedure like this, can’t likely get health insurance that might pay for a procedure like this,etc. because she is in prison? I know, she’s in prison because of her own actions… maybe. But what about the idea that there is a chance of an innocent person being in prison, thus being rendered financially incapable of paying for something like this? How does that factor into our debate?
Most likely, she never would have been able to afford it anyway. A prostitute is not a likely candidate for a loan, nor do they generally have the fiscal responsibility to save money. She’s probably never had a bank account, or established a credit history. Perhaps she would have somehow pulled herself up out of that lifestyle, to get a college degree and a job which offers insurance benefits, but frankly, the odds are against it.
Even if she is innocent, her poverty would have worked against her, including in the criminal justic system. The poor and indigent can’t afford Johnnie Cochoran’s fees, and generally end up with an overworked and underpaid public defender. With no offense intended toward these people, defendents who cannot afford attorneys sometimes don’t get the same level of zealousness as they would with a private-sector defense attorney.
Sadly, this woman was probably doomed from her youth. Most likely, she grew up in a poor family, perhaps with physical or sexual abuse, and she probably was not well-educated. Most likely, the only career options open to her involved flipping burgers, and if she became addicted to drugs, her life went on a downward spiral, ending up as a prostitute. Had she not been incarcerated, her life would most likely have been “nasty, brustish and short.” She could have been killed by a client, died of an overdose, or from her various illnesses.
It is highly unlikely that her incarceration has limited her career opprotunites, or that of getting health insurance which would have afforded a transplant. Poor she was, and poor she would have remained, and it’s only through the circumstances of her incarceration that she is given an opprotunity that folks on the “outside” are denied. Incarcertion has not removed from her any advantages that she might have enjoyed as a free person, but has, in fact, increased them.
** irishgirl, ** in a perfect world, I would agree with you fully, but in a country in which the size of your bank account, or the quality of your insurance dictates whether you will get life-saving transplants, I seriously can’t see extending benefits to incarcerated people that the average poor person does not have. I would love to see everyone recieve the best care our advanced medicine can provide, but medicine is capitalistic. If you can’t pay, you will die, pure and simple. If this applies to “good” people, should it not also apply to “bad” people, as well?
If anything, the poor, but law-abiding, should be given these benefits before inmates who have abused the very system which now must care for them. Yes, inmates are people too, who deserve to have their rights protected, but I can’t see giving them privlidges that are not extended to the poor.
It is not necessarily a moral judgement. Our system requires that you pay to play, regardless of how deserving, or undeserving you are. Should incarceration actually give you an “edge” when it comes to medical treatment?
irishgirl
I don’t see the slippery slope here. The slippery slope, in any event, is not a logical reason for doing something, absent some evidence that a step in that direction is likely to lead to further steps in that direction. There is no indication that providing medical care only equal to that of the free poor would lead to further reductions in the future.
While I agree with you in general, re everyone is entitled to medical care, when it comes to organ donation, where there will always be a need for more organs than are available, I think the drug abuser/smoker/alcoholic should go to the back of the line. Why should someone who has, through their own actions, destroyed their first organ be entitled to receive a new one before a person who has lost an organ to a disease over which they had no control?
i’m just so used to living in a country which provides medical care free to everyone. the free poor get about the same care as everybody else here.
and Rhum Runner, there’s a very slippery slope.
if i give 2nd grade care to criminals and those who are “responsible” for their illnesses, where you draw the line?
eg
obesity contributes to many diseases, do i refuse to treat obese people with such diseases?
what about the merely overweight ones?
smoking contributes to many diseases, should i refuse to treat all smokers with such diseases?
what about former smokers?
occasional smokers?
non-smokers who live with smokers and allow them to smoke in the house?
driving a motor vehicle can cause accidents, do i refuse to treat the driver involved in an RTA?
do i refuse to treat all the people with skin cancer who ever used tanning beds?
all the people with STDs who ever had unprotected sex?
all the extreme sports enthusiasts?
all the victims of DIY accidents who didn’t wear goggles, gloves and a flame retardant outfit?
any of these people are as culpable for their health problems as the lady in question.
there should be one rule in medicine as regards treatment.
I think the distinction you are missing is that the number of persons who may receive organ transplants is limited by the number of such organs that are available. There is no reason to believe that by taking the alcoholic out of the liver transplant pool that the obese diabetic will be denied insulin in the future. The supply of insulin is unlimited, the supply of livers is not.