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  • Writer's pictureSociety of Bioethics and Medicine

Incentivizing Organ Donations with an Earlier Inmate Release Date in Massachusetts

Written by Sultona Davlatova

Edited by Silvia Hanna

“I would give an arm and a leg to get out of here.” You may have heard a phrase like that before. But really, would you give an organ? Would you be willing to give your bone marrow?

On January 20th, Massachusetts state representatives Carlos González and Judith A. Garcia proposed a new bill, HD.3822, that would allow prisoners to donate their organs or bone marrow for a reduced sentence of 60 to 365 days. Many have opposed it, heavily questioning its ethics. However, the representatives who proposed this bill remain adamant on its morality.

González and Garcia have asserted that their program would help to combat the severe ongoing organ shortage in the US and other nations. González states that this proposed bill would be an effective way of offering more people the option of donating, thus allowing for a wider array of potential organ donors. He claims this would then “increase the likelihood of Black and Latino family members and friends receiving life-saving treatment.” This is important to note because BIPOC have historically had a harder time getting organ transplants than their White counterparts. For example, even though African Americans make up the largest group of minorities in need of an organ transplant, in 2021, only 27.8% of the non-Hispanic Black people on waiting lists received organ transplants, compared to the 47.2% of the non-Hispanic White people waiting.

González further states that this proposed bill would allow prisoners individual agency. Garcia, in a post on Twitter, supported this claim stating that it would, “restore bodily autonomy to incarcerated folks by providing opportunity to donate organs & bone marrow.” Additionally, if this bill were to be passed, the program would be run by a committee of five people to ensure each participant’s safety, including DOC (Department of Corrections) leadership, an organ donor specialist, two people from the Massachusetts District Attorney’s Association, and a prisoners’ rights group. Still, many question how this program would actually affect the prisoners being subjected to the option of donating parts of their body for freedom.

The main problem that many have with this bill is that they feel it preys on the strong desire that most incarcerated individuals have for freedom. They claim that many inmates will not be able to make a decision that is well-informed and fully thought out because they may be in a state of deep distress, and desperate to get out of prison. Additionally, critics question how well incarcerated individuals would be taken care of if donations were to take place. Given the fact that correctional facilities are not known for their adequate healthcare, many worry this would be yet another after-effect that would harm these prisoners.

Those in opposition to the bill also argue that since ethnic and racial minorities are overrepresented in prison populations, this bill could be seen as a way of exploiting these populations. Although one of González’s main aims was to lessen the racial inequities of organ donation recipients, many view this program as a terrible way to do so. As one of the bill’s many critics, Jessica Hamzelou of MIT Technology Review states, “there are other ways to inform minority communities about organ donation and encourage informed decisions about it. And they shouldn’t involve trading organs for freedom.” Takunda Matose, a bioethicist at Loyola University Chicago who has worked in incarceration settings, has a list of recommendations, including improving medical care at prisons that lack it, broadening committee membership to be less focused on prison staff, and tracking the racial demographics of people who are donating, and people who are recipients, to ensure equity.

In addition to the many ethical issues that have been brought to light, it is argued that incarcerated individuals may also be hesitant to be fully transparent about their medical history. This is problematic because doctors routinely ask would-be donors about their health, well-being, ability to look after themselves, and whether they smoke or take recreational drugs. These factors will affect not only whether their organs are suitable for donation but how likely they are to recover well from the procedure. This point circles back around to the assertion that incarcerated individuals will have a very difficult time making a sound decision that will not harm themselves or the person their organ is being donated to with the incredibly desirable possibility of an early release date seemingly just within their reach. Moreover, those who oppose the bill also say that exchanging organs for less time inside breaks away at what the justice system is supposed to be, a place where individuals are rehabilitated. When you incentivize bone marrow and organ donation for less time, it can be seen as violating the core foundations of the justice system.

On top of all these pitfalls, this bill also possibly violates federal law, per the National Organ Transplant Act of 1984, which makes it unlawful to “knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation.” In other words, this law makes it illegal for individuals to receive compensation for their organs, as the ethical concern for respecting human body parts or deceased remains is an utmost concern of legislators in Congress. An earlier release date from prison may be seen as “compensation”, hence why many officials doubt the bill would even get passed. Additionally, there was a similar bill proposed in 2007 in South Carolina, which sought to reduce sentences by up to 180 days if a prisoner donated an organ. However, it turned out to be unsuccessful.

Incarcerated individuals have been seen time and time again to be taken advantage of by the government. Yet, there is no doubt that there is a dire need for organ donations, as 105,800 individuals, including children, are on the national transplant waiting list. So, what can be done to solve this dilemma in an ethically sound and effective way? Would the benefits of this bill far outweigh any potential harm if it were to be passed? Do the ends always justify the means, or is this simply moral depravity?


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