The Ethics of Organ Transplants: The Current Debate

By Arthur L. Caplan; Daniel H. Coelho | Go to book overview

30. Should a Criminal Receive
a Heart Transplant?
Medical Justice vs.
Societal Justice

Lawrence J. Schneiderman
and Nancy S. Jecker


1. INTRODUCTION

De Wayne Murphy was described in a New York Times article as "desperately ill with cardiomyopathy, a progressive weakening of the heart muscle." 1 The story went on to say that under ordinary circumstances he would be a candidate for a heart transplant. But Mr. Murphy's circumstances are not ordinary: he is in a federal prison hospital in Rochester, Minnesota, and the Federal Bureau of Prisons which is responsible for his medical costs refuses to pay for a heart transplant.

The reporter suggested that the case "raises troubling questions about access to health care for those in the criminal justice system" 2 and enumerated them as follows:

Should the nation provide expensive care and scarce organs to convicted felons? Can it justify a system in which an estimated one in four employed Americans cannot have a transplant because they are uninsured or underinsured, yet ask the Bureau of Prisons to provide them for prisoners? If the Bureau will not pay for a transplant, should it pay for a quadruple bypass? Or looking at it in another way, should a nonviolent criminal like Mr. Murphy get a heart transplant but a murderer or rapist not? What about someone convicted of a white collar crime, like tax fraud? Where, if at all, should society draw the line? 3

The reporter went to two prominent medical ethicists for opinions on the case. Their comments suggested that from an ethical perspective such

____________________
Originally published in Theoretical Medicine 17( 1996): 33-44. © 1996 Kluwer Academic Publishers.

-294-

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