Massachusetts Proposes Reduced Sentence for Inmates Who Donate a Kidney, Part of a Liver, or Bone Marrow

Surgeons at a New York hospital examine a patient for possible rejection of a pig kidney, in September 2021. Joe Carrotta (AP)

A sentence reduction of between 60 and 365 days in exchange for a kidney, liver section or bone marrow extraction.

The bill that the Massachusetts State House of Representatives is trying to move forward raises a deep bioethical debate.

Is it legitimate to take advantage of an organ?

Is it possible to give up one for mercantilist desire, in this case the purchase of a few days of freedom?

The answer, if any, may affect the fate of the 6,000 inmates in the prisons of the liberal Bay State, as Massachusetts is known, and by extension the rest of the US prison population.

The bill has been sponsored by Democratic lawmakers.

In front of them are not a few human rights activists, who flatly reject the proposal.

Michael Cox, executive director of the Black and Pink Massachusetts prison abolition organization, has called the move "unethical and depraved."

"Incentivizing the sale of parts of your body in exchange for the most precious asset in the world is simply appalling," Cox said in statements collected by the digital newspaper

.

The ethics committee of the US National Transplant Network (UNOS), constituted as a non-profit association, has also criticized this type of initiative.

"Any law or proposal that allows a person to exchange an organ for a reduced sentence raises numerous problems," says an official statement published on its website.

If freedom, as the activist Cox emphasizes, is the highest good, what is health, in a country that treats it like a commodity?

In the State of New York, since the end of last year, living donors have received a grant of $10,000 as reimbursement for hospital expenses derived from the intervention.

It is the first state program in the country that allows individuals to pay back the cost of donating a kidney or a liver.

"Living organ donors are true heroes, and with this legislation we are taking significant steps to support their sacrifice and save lives," Governor Kathy Hochul said in signing the bill.

The pioneering New York legislation has a reason: it is one of the states at the bottom in number of donations.

At the end of December, when the law was adopted, there were 8,569 people on the waiting list for a transplant, of whom 7,234 needed a kidney.

A trend that can be extrapolated to the rest of the country, according to the national transplant network: the US alone reached one million transplants last year, "a historic event" according to the organization, but more than relative in a total population of over 330 million. population.

According to UNOS, just over 104,000 Americans are currently waiting for an organ.

Between January and December 2022, those from 21,368 donors (living and dead) made 42,888 transplants possible.

In the same period, there were more than 6,400 living donor operations,

precedents

Ruled out, by law, the donation of organs from prisoners executed in the States that still apply the death penalty ―the majority die as a result of a cocktail of drugs―, only the living remain as a

population , hence the Massachusetts initiative be seen as a test bed for the rest of the country.

But the commercial transaction inherent in Massachusetts law, the reduced-sentence incentive, also raises legal questions, not just ethical ones, since the National Organ Transplant Act of 1984 prohibits the exchange of an organ for a “valuable consideration”.

In 2007, South Carolina lawmakers considered a proposal similar to the one in Massachusetts that would have reduced prison sentences by up to 180 days in exchange for donations.

But critics debated its legality, and the state eventually adopted a voluntary organ and tissue donation program that lets incarcerated people donate without compensation.

Additionally, the Federal Bureau of Prisons allows prisoners to donate their organs while incarcerated, but only to immediate family members.

In 2013, Utah allowed the release of prisoners who died while behind bars.

Most other states do not allow inmate organ donation.

The Massachusetts bill, which was introduced in the state House in January, raises two other major issues: the high prevalence of infectious diseases among the prison population (AIDS, hepatitis, tuberculosis, among others), which introduces suspicion about of the suitability of the organ, and the pronounced racial inequality in the precarious balance between donors and beneficiaries, and always against the latter.

The organization Prisoners' Legal Services of Massachusetts, which advocates to reform the prison system, has reminded the promoters of the initiative "the racial inequality in our health system, which has left BIPOC communities [acronym in English of blacks, indigenous and people of color] disproportionately affected by organ and bone marrow shortages.”

While the debate continues on the networks, the scale of sentence reduction has yet to be established in the event that the law goes ahead: how many days in exchange for which organ or which piece of that other.

Difficult metric, given the lack of precedents and measuring rods;

a decision that will correspond to a special committee of five members in which only one of them advocates for the rights of prisoners.