a Heart Transplant?
Medical Justice vs.
Lawrence J. Schneiderman
and Nancy S. Jecker
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____________________