Once a treatment has become the standard in the community, prisoners should not be denied it solely because they are incarcerated, according to ethical and legal experts. The U.S. Supreme Court concluded in a 1976 case that state and federal governments have a constitutional obligation to provide health care to prisoners, said Richard J. Bonnie.
Three federal prisoners with kidney failure said, in recent letters to a reporter, that after the policy was changed in February, 2001, they requested medical evaluations for possible transplants. However, they said they have yet to receive them.
"The medical staff here is trying to discourage dialysis patients from receiving kidney transplants, period," wrote Michael Walker, a prisoner on dialysis at the Federal Medical Center (FMC) Devens in Ayers, Mass.
David Lee Smith, a prisoner at the U.S. Medical Center for Federal Prisoners in Springfield, Missouri, said that since March he has twice requested a transplant evaluation from a kidney specialist at the prison but has received no response. Smith said he has a brother whose tissue type is a good match for his who may be able to donate a kidney.
Sylvester Clay, another FMC Devens prisoner wrote: "I was told by medical staff that everyone would receive an evaluation but it has not happened. At this point all transplants have been put on hold."
"It sounds as if the Bureau of Prisons is continuing to act as a bad HMO," said Elizabeth Alexander, director of the American Civil Liberties Union's National Prison Project.
168 prisoners, housed in three federal prisons, are on dialysis for endstage kidney failure. Despite medical studies that show that people on longterm dialysis have much higher death rates than kidney transplant recipients, most prison systems make it difficult or impossible for prisoners to obtain transplants. In contrast, outside of prisons, the federal Medicare program covers the cost of treatment, including transplants for all Americans with endstage kidney failure.
Ten state prisoners are on a waiting list for kidney transplants in Virginia, one of the few states whose prison system routinely refers prisoners for transplants and pays for the surgery. "I try to adhere to the standard of care on the outside," said M.J. Vernon Smith, a former transplant surgeon who is chief physician of the Virginia DOC "Our state pays for transplants" outside prisons. "I can see no ethical or reasonable reason why I shouldn't do it."
Source: Washington Post.
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