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California Prisoner Gets New Heart

In early January 2002, an unidentified California prisoner received a heart transplant at the Stanford Medical Center. It was the first time any state prisoner has received an organ transplant; and it is not without controversy. Inflated prison populations, longer prison sentences, and an aging prison population make prisoner health care a hot topic. Diseases like AIDS and hepatitis C, rampant in the prison community, are fuel for the fire. Add to this the scarcity of donor organs and you have all the ingredients for a raging inferno of controversy.

Russ Heimerich, spokesman for California DOC says, "We don't have a [prison] policy per se.... The courts have told us that inmates have a constitutional right to health care." Then, with a touch of sarcasm, he adds, "You and I don't, but inmates do."

The 31-year-old prisoner that received the transplant is serving a 14-year sentence for robbery. Under normal circumstances the state would circumvent the responsibility for providing the transplant by releasing the prisoner. "What they do is trigger early release or compassionate release to get the inmate out of the system," said Scott Chavez, vice president of the National Commission on Correctional Health Care. "That way they avoid having to do the transplantation and having to pay for it." In this case, however, the prisoner is not eligible for parole until 2008.

The organ donor process does not discriminate against prisoners. Denial is only considered "indirectly when it comes to criteria like following doctors' orders..." said Anne Pasche, a spokeswoman for the United Network for Organ Sharing. "But being in prison doesn't disqualify someone," she said.

Estelle v. Gamble , a 1976 Supreme Court ruling held that the Eighth Amendment protected prisoners from "deliberate indifference" to their health problems. Subsequent cases have cemented the ruling. Heimerich points out, "We have a requirement, based in law and in losing many, many lawsuits, to provide medically necessary care to inmates." According to a report from the governor's office medical suits by prisoners cost the state $2 million in settlements over the last year. A much higher amount in verdicts is being appealed. DOC officials estimate that medical expenses for the transplant patient will cost the state about a million dollars before he is released.

Currently, organ recipients are selected from a list that matches the donor organ with the most compatible candidate. They are then ranked according to age, gender, geographic proximity, immediacy of need, and likelihood of success. In this case, the prisoner who received the heart has a 70% chance of living at least five more years. As Heimerich points out, "[the] judge did not sentence this guy to death." "Who knows?" he said. "He may get out and become a productive citizen." His words are accurate, but one gets the
impression that Heimerich is not comfortable with the truth.

Source: The Sacramento Bee

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