A man named Scott Johnson is slated to be executed by the state of Indiana on May 25. He is asking that his execution be delayed long enough so that he can be tested as a possible organ donor for his sister.
There is an ethical medical question involved as to the harvesting of the organ:
I guess there are really two questions here. Should Johnson be allowed to delay his execution in order to determine whether he can donate his liver to his sister and would it be ethical for doctors to harvest his liver immediately following the execution.
My answer to both questions is yes. If he can save a life, why not let him? In fact, why aren’t we harvesting organs from all executed convicts?
I realize the medical ethics are weird but as long as the surgeons are not involved in the actual killing, then I just see it as moving to save the life of someone else.
The drugs used in the lethal injection will render the organ unsuitable for transplant. Further, organ donors are not allowed to chose the recipients of their organs, except in the case of kidneys. It has to go to the next person on the list. This is to avoid cases like Mickey Mantle, when celebrities or rich people or whoever move to the top of the list because of their status.
Further, this debate has been going on in Indiana for at least a week. According to the Indy Star, the average wait time for a liver donation is less than 20 days. So she probably could have gotten a liver by now if she weren’t screwing around with all these appeals.
Barring any practical issues, I’d have no problem with it. Potentially dangerous drugs could probably be flushed out with perfusion, which is a standard part of the grafting procedure anyway, so I doubt any insurmountable practical issues exist. I see no form of complicity on the part of any MD who is recruited to harvest the organ(s). The individual is most certainly going to die, so once the convict is declared dead, I see no difference between havesting organs from that homicide victim and any other homicide victim. If the doctor could do somthing to stop the death of the convict, of course he or she would be ethically bound to do so; but since the doctor can’t, that’s a non-issue.
Hrm. The potassium chloride might be a problem (not all states use this anyway), but would there be aywhere near enough thiopental and pancuronium left over to be toxic if the liver were perfused? I suppose SOP for this sort of thing might preclude use in any event, but I wonder if the organ would in fact pose any danger to the recipient after having been prepped for engraftment.
Whats so special about kidneys? Anyway, this is just not true. If my wife needed a partial liver transplant and I was compatible I could say I will donate to her and to her only. Anybody else could as well.
*Eric Meslin, director of the Indiana University Center for Bioethics, said few if any doctors would assist someone in committing suicide by organ donation.
For all organs except kidneys, the rules that govern organ donation prohibit a person from selecting who gets it, Meslin said. The organ goes to the person at the top of the waiting list, he said.*
I don’t have a problem with it. He’s not asking to have his sentence overturned, to be set free. What’s the hurry to kill him that it should kill his sister as well as himself?
He seems misinformed. Parents have donated lobes of their livers to children in the past, and bone marrow donors are often sought out among the relatives and families of patients who need the marrow.
I don’t know for sure, but it wouldn’t surprise me if it took longer than that. Lots of various compatability factors to test for, on a molecular basis, between donor and recipient.
I bet KarlGauss would know! He’s a scholarly doc. Or DoctorJ, if he’s done a transplant service rotation recently.
No transplant service experience here; it’s the one thing we don’t do at our hospital. (We do harvests, but not transplantations, and I’m not involved.) If I remember back to medical school, though, livers are just matched just by ABO blood type and size. For reasons I don’t remember (if I ever knew them), it doesn’t require the careful immunotype match that, say, a kidney does. So it’s one blood draw and an MRI; a couple of hours, tops.
(A quick search confirms my remembrance. In fact, in one study, patients who got livers that weren’t even ABO matched didn’t do too badly.)
There’s no way they’d take a liver after an execution; organ donors have to be damn near ideal, since it’s such a complicated process even in an ideal setting. I was asked to come to the OR a few months ago to weigh in on whether a lesion on a potential donor’s forehead looked cancerous. They said that unless they could be absolutely sure that it wasn’t, they had to cancel the whole deal. (It looked pretty damn suspicious.)
There’s also no way the doc is going to get the liver while he’s alive. Doctors are pretty expressly forbidden to be involved in executions; there was recently some controversy over whether Kentucky’s governor, a physician, should lose his medical license because he signed a death warrant. (My reading of the bylaws said that he should have, if you want to be strict about it. It didn’t go anywhere.) Even if you try to cut it fine by saying that the doctor will remove the organ and then they’ll push the juice, so that the doc isn’t doing the killing, you have to allow for the possibility that the pardon finally comes through just after the doc closes him up.
So I really don’t see an ethical way to get that liver to her.
I suppose I should have just googled it to begin with but this site confirms what you said ** DoctorJ **
[quote]
Recipient selection is based on blood type, body size, medical urgency, and length of time on the waiting list. The heart, liver and lungs are matched by blood type and body size. In matching the pancreas and kidneys, genetic tissue type is also considered.
[quote]
It seems that the viability of transplantation should be able to be done in a week. If he is indeed a match then execute him in a way that preserves the liver for transplantation and on a date and location that is suitable for the sister to get the transplant. Is there something I am missing here or is this an open and shut case so to speak?
