Not everyone is enthusiastic about prisoners becoming donors. Inmates have a higher rate of diseases and infections that could make transplantation dangerous or impossible, such as HIV and hepatitis. Organs and tissues are tested before transplantation, but bacterial infections and unknown disease are still a risk.
Considered a "high-risk" population, the incarcerated can donate living tissue or organs (such as kidneys or bone marrow) to immediate family members only. Most states do not allow deceased donation for inmates.
Greater still are ethical concerns. The United Network for Organ Sharing views policies that reduce sentences or give parole in exchange for donation as "valuable compensation," rendering them unethical. And while prisoners can receive organs and are placed on the national waiting list, donation is different.
"Many maintain that prisoners cannot consent freely, given the nature of the environment in which they live," wrote Arthur Caplan of the University of Pennsylvania for the American Journal of Bioethics in 2011. He argues that prisoners aren't allowed to participate in medical research for the same reason.
"The ability to comprehend the facts about donation and to make a voluntary choice must be carefully weighed," wrote Caplan. It's too difficult to ensure the decision isn't a compromised one — for prisoners, true informed consent isn't possible.
Some recipients are also reluctant to accept life from those that once took it.
Wesley Hill, a Salt Lake City resident who received a heart transplant with only days to spare, said as long as the organs and tissues are healthy, he doesn't see why inmates shouldn't be able to donate. But his concern grows with the length of the rap sheet — could he accept a heart from a murderer? Hill says he'd be opposed to receiving an organ from someone on death row, but the decision is tough.
"It's just so hard. You're on your deathbed. How desperate are you?" Hill says. "If they had nothing else, I'd think twice about it."
More need, more executions?
After nine months of living with a painful cracked cornea in his right eye, Kay Wells was delighted when his doctor informed him he had a donor. Kay received his first cornea transplant the morning of Jan. 17, 1977 — two hours after convicted murderer Gary Gilmore was executed by firing squad.
After surgery, he scarcely batted an eye when the National Inquirer tracked him down and told him it was Gilmore's.
"(The reporter) asked me if my attitude toward life had changed with a killer's eye," recalls Wells, now 63. "I said, 'Yeah, I really hate reporters now.’ ”
Jokes aside, after the paper confronted him, Wells confirmed with his eye doctor, opthalmologist Oliver Richards Jr., that he did indeed have Gilmore's cornea. With several patients in need of cornea transplants, Richards told Wells he had visited the Utah State Prison and asked Gilmore to consider donation. The prisoner, who had pleaded for the death penalty, agreed.
Richards has since died, so there's no way to confirm the story. But true or not, years later, Wells has no qualms about having possibly received a "killer's eye" and remains firmly pro-donation.
"I was just grateful I was able to get the cornea," Wells said. "I think we need as many organs as we can get. I'll give ’em anything they want, and I'll support anyone that does, whether they're a man on the side of the street or a man in prison."
While only 1 to 2 percent of deaths allow for organ donation, state executions, which occur under highly controlled circumstances, could provide a unique opportunity for transplantation. Execution practices in the U.S. today preclude organ or tissue donation, but death row inmate Christian Longo made a stir in 2011 with a letter to the New York Times requesting to donate his organs after execution.
"If I donated all of my organs today, I could clear nearly one percent of my state’s organ waiting list," wrote Longo. "I am 37 years old and healthy; throwing my organs away after I am executed is nothing but a waste."
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