MAKING
EXCEPTIONS TO THE RULES:
SHOULD
PRISONERS
BE
PERMITTED TO DONATE THEIR ORGANS AFTER EXECUTION?
AN
OPEN LETTER TO WARDENS, GOVERNORS, & ORGAN-PROCUREMENT DOCTORS
Someone who deeply understands a rule knows
how to make exceptions.
Deep understanding requires a grasp of the
underlying reasons
for the rule.
This open letter presents the five major reasons
now standing in the way of organ donation after execution:
1. ORGANS FROM PRISONERS ARE LIKELY TO TRANSMIT DISEASE.
2.
ALLOWING PRISONERS TO 'DONATE' ORGANS AFTER EXECUTION
WILL LEAD TO
COERCION, MANIPULATION, &
IMPROPER TAKING OF ORGANS.
3.
MOST METHODS OF EXECUTION ALSO DESTROY THE ORGANS.
4.
DOCTORS SHOULD NOT KILL.
5. CAPITAL PUNISHMENT IS EVIL—AND
IT IS BEING ABOLISHED.
6.
LINKS FOR FURTHER EXPLORATION.
MAKING
EXCEPTIONS TO THE RULES
by James Leonard Park
Up until now, we in the United States of America have
had firm rules
that prevent organs from being harvested
from condemned murderers after
execution.
There were a number of good reasons for
this prohibition.
But if each and every
one of these counter-indications
can be overcome in a specific instance,
then the organ-donation could go forward.
At least at first, there will be no change of the general rules.
It will not become a
general policy to remove organs from the executed.
But if the first few exceptions to the rules
prove that the reasons for the prohibition
do not apply in those
specific cases,
then good policies for
making further exceptions could be considered.
Making a wise exception to the general rule against
organ-donation
is a challenging opportunity.
Let's see if each of the objections can be met one-by-one.
1. ORGANS FROM PRISONERS ARE LIKELY TO TRANSMIT DISEASE.
Organ-procurement specialists are first and foremost
responsible
for making sure that any donated organs will not harm the recipients.
Prisoners probably have more diseases than the
general public.
Therefore accepting organs from prisoners might transmit more
disease
than using the organs of accident victims from the general population.
Normally the time-frame for organ-procurement is
very short:
The donated organs must be tested and approved right now.
Even short delays will cause the organs to deteriorate
so they cannot be brought back to life in the body of the recipient.
How should we make exceptions to this rule against
prisoners' organs?
In the rare case
of a prisoner donating
organs after execution,
the condition of the organs
can be exhaustively tested
while they are still operating in the living body of the donor.
Tests can rule out all the
common diseases of
prisoners.
If these specific organs are certified to be free
of disease,
they will be better for transplant than random organs from the public.
We do not prohibit donations from motorcycle riders
because they as a group have a higher disease-rate than the general
public.
Rather, when someone dies in a motorcycle crash,
the organ-procurement team checks for all likely diseases.
Based only on the verifiable condition of
these specific organs,
wise thinking can make exceptions to the rule
about organs from
prisoners because of the danger of disease.
The rates of various diseases in prison-populations
can be studied.
Careful investigation will show which prisoners do not have these diseases.
And particular organs offered for donation after death
can be certified to be healthy
and disease-free.
Because we have as much time for medical testing as
needed,
the actual function
of the organs to be donated can be measured
while they are still
operating within the body of the donor.
This will be a new experience for the organ-procurement team,
since they are usually not
called until after the donor is dead.
Some of the organs might have been damaged
by the
prior life-style of the prisoner.
Drug and alcohol abuse might make some organs useless for
transplant.
Deep investigation can evaluate the functions of each organ.
Only body parts certified to be working well
and free of disease
will be considered for transplant.
2. ALLOWING PRISONERS TO
'DONATE' ORGANS AFTER EXECUTION
WILL LEAD TO COERCION,
MANIPULATION,
& IMPROPER
TAKING OF ORGANS.
The widely-reported taking of organs from
prisoners in China
has created a very bad image in the minds of many who consider
American prisoners 'donating' their organs after
execution.
We prevent prisoners from making many decisions for themselves
simply because the fact of
being in prison makes their
decisions unfree.
Whenever we hear that prisoners in other countries
'voluntarily donated' their organs after execution,
we doubt the voluntariness of any such
'donations'.
Were these prisoners manipulated or coerced?
Since we are rightly skeptical of 'donations' in
less developed countries,
how can we expect U.S. prisoners to be any more free?
If an American prisoner has freely and voluntarily
reaffirmed
his or her wish to donate organs after execution,
this can be verified by multiple methods involving many outside
observers.
At least one year should be devoted
to the process of discovering the
settled wishes of the prisoner.
Some possible methods of verification are described here:
"Can a Prisoner Ever Make a Free Choice?"
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/FREE-PRI.html
When
most of these ten safeguards have been fulfilled,
we can be fairly certain that this particular donation is voluntary,
but we should resist the tendency to let the safeguards slide
for subsequent organ-donations from executed prisoners.
Carefully following the defined guidelines for making exceptions
will mean that coercion, manipulation, & fraud
are eliminated from every organ-donation after
execution.
Even distant doubters must be convinced
that the prisoner in each
case has genuinely made a free choice.
3. MOST METHODS OF
EXECUTION ALSO
DESTROY THE ORGANS.
When execution of condemned prisoners
was achieve
by poison gas or electrocution,
then the organs of the executed person
were also made hopelessly useless for transplantation.
These methods of execution were chosen specifically because
they cause sure and certain
death within a few minutes.
Beheading and firing-squad caused instant death.
When methods of execution were decided by the state
legislators,
they never considered
the possibility that the executed prisoner
might want to donate his or her organs after execution.
But, as it happens, one method of lethal injection
(sodium thiopental)
might be a good way to
achieve brain-death without harming organs.
And if this drug is not as ideal as another lethal chemical,
then the law could be changed or an exception could be made
so that everyone would know that the prisoner has really been
executed.
But in addition, his or her organs
are still suitable for transplant.
Once we have decided to consider exceptions
that will permit organ-donation after execution,
then willing medical experts can confer
to decide the very best method to make absolutely certain
that the prisoner has really
been executed
—that
he or she is completely and irrevocably dead—
and the organs to be donated were
not harmed by the
execution.
Further discussion of this useful exception will be
found here:
"Brain-Death Protocol for Voluntary Execution followed by Organ
Donation":
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/BDP-VX.html
When
organ-procurement specialists decide to consider this exception
to the general rule that executed prisoners may not donate their
organs,
they will think very carefully about the best ways to protect the
organs
so that they can be transplanted without problems for the recipients.
Wise advance planning can make certain that this brain-dead donor
has better organs
than most other donors coming to the transplant
center.
4. DOCTORS SHOULD NOT KILL.
Various medical societies and other organizations
have established policies that (in their strict enforcement)
would prevent doctors even from consulting about execution.
But we know that doctors have the exclusive power to
declare death.
Therefore, a few doctors have always been involved with executions.
These are doctors either employed by the prison system
or other doctors who have consented to make an exception
to the general rule that they should not cooperate
with any process
that brings death.
Organ-procurement doctors who offer their expertise
will do so completely voluntarily—not
under any coercion.
And we would not need any elaborate proof
that such doctors are making a free choice
to cooperate in such a new
avenue
for medicine.
Perhaps most organ-procurement specialists will never cooperate.
But they should not attempt
to prevent other doctors from
cooperating.
The greater good of saving several lives
should overbalance any general rules about avoiding
executions.
Transplant surgeons know in their own hands
how lives can be saved by transplanting human organs.
Every day they save the lives of actual patients they know.
At least some of these doctors who save lives
will overcome any ethical qualms about the source
of the organs.
Cooperating doctors will not
become executioners.
But they will advise about the best methods for achieving death
while doing the least
possible harm to the organs to be donated.
And if several lives are saved that would
otherwise be lost,
the general public will side with the doctors who made exceptions
to the general rules preventing doctors from cooperating with
executions.
And fellow doctors will not condemn the first doctors who
cooperate
for their willingness to go beyond the old practices
because of the greater good achieved by the organs harvested.
When we line up the smiling pictures of the living
patients
who would be dead except for these donated organs,
transplant surgeons will know they were wise to make these
exceptions.
The transplant-team did not kill anyone.
That decision was made by the judicial process of the state or country.
But the transplant center wisely made an exception to its general rule
against organs from executed prisoners.
Both the donors and the
doctors made completely free choices.
5.
CAPITAL PUNISHMENT IS EVIL—AND
IT IS BEING ABOLISHED.
Executing prisoners for capital crimes is surrounded
by controversy.
Where death is still a possible punishment for the worst crimes,
this penalty is not applied equally to all who commit those crimes.
Also, some people executed were later proved to be innocent.
For these and other reasons, the practice of putting criminals to death
has slowly been disappearing from the planet Earth.
And even where the death-penalty is still used in
the Western world,
the process of automatic appeals and other delays often means
that condemned prisoners spend many years on death-row.
Therefore, since the population of death-row will
continue to shrink,
there will be fewer prisoners to donate their organs
after execution.
Even in jurisdictions where the death-penalty is
still in use,
many people (including transplant professionals)
do not agree with this method for punishing capital crimes.
Thus, even if prisoners wish to donate organs after
execution,
some transplant professionals refuse to participate.
And it is certainly consistent for opponents of the death-penalty
to distance themselves from any practice they consider
barbaric.
These valid reasons for rejecting organ-donation
after
execution
can be protected by the following safeguards.
First, the prisoner on death-row must confess
that he or she did commit
the crime (such as murder in the first degree)
for which the death-penalty has been correctly and fairly imposed.
This should remove any worry that an innocent person might be
put to
death.
This fact of guilt should be acknowledged at least 12 times
over a period of at least one year.
And at the same time, the prisoner can reaffirm his or her decision
to donate all usable organs after execution.
Open confessions and several other safeguards
to make sure that the execution and
donation
are completely voluntary are discussed in the following essay:
"Can
a Prisoner Ever Make a Free Choice?"
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/FREE-PRI.html
The fact that
capital punishment might be abolished in coming decades
means that there will be fewer and fewer prisoners waiting on
death-row.
Thus, we should not consider organ-donation
from such a small and diminishing pool of potential donors.
It is just not worth the controversy
to allow prisoners on death-row to donate their organs after execution.
A surprising reply to this objection
is that execution could
become voluntary.
Instead of imposing the
death-penalty after guilt has been established,
some jurisdictions might impose life-imprisonment
with the option of voluntary
execution after at least one year in prison.
Each capital felon would choose his or her own date of execution.
—or choose to remain in prison for the rest
of his or her natural life.
Also, other prisoners who will spend the
rest of their lives behind bars
might be given the option of
choosing a voluntary execution
(perhaps followed by organ-donation)
instead of waiting for natural death in prison.
Even if less than one in a thousand prisoners
serving life-sentences without the possibility of parole
were to consider voluntary
execution instead of natural
death in
prison,
this would increase the potential pool of willing organ-donors.
And each jurisdiction that abolishes
the death-penalty
might consider offering the
option of voluntary execution.
This
possibility is
explored in detail in the
following on-line essay:
"Voluntary Execution: Better than
Capital Punishment?":
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-VX.html
A few 'lifers' might want to make their
deaths more meaningful
by opting for voluntary execution near the natural end of their lives
so that they can donate their viable organs to strangers
who will otherwise die because their own organs are failing.
The death-penalty might be abolished,
but thousands of prisoners will still die each year in prisons.
When prisoners die of natural causes (or from violence or
suicide),
they are permitted to
donate their usable organs.
Why should we discriminate against inmates who will die by execution?
Why not permit all willing
prisoners to donate their organs after
death?
6. LINKS FOR FURTHER
EXPLORATION.
Since you have read this far,
you might be one of the wardens, governors, or organ-procurement doctors
who will lead the way toward
the very first
organ-donation from an
executed prisoner.
If you are at least somewhat inclined in the
positive direction,
here are some additional links that you or other colleagues
might find useful in supporting your case for making exceptions
to the general rules preventing organ-donation from prisoners:
Portal for ORGAN DONATION AFTER EXECUTION
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/P-ORGAN.html
This
portal will attempt to keep current with all websites
that support the freedom of prisoners
voluntarily to donate their organs after execution.
PRISONER ORGAN DONATION
http://www.facebook.com/pages/PRISONER-ORGAN-DONATION/106888752666731
This is the name of a Facebook Page devoted to winning the right
for willing prisoners to donate their organs.
Like-minded persons from every walk of life
are welcome to join this Facebook community.
BRAIN-DEATH AS A METHOD OF VOLUNTARY EXECUTION
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/BRAIN-D.html
Would
brain-death satisfy the requirement of
execution
while at the same time preserving some organs for transplant?
BRAIN-DEATH PROTOCOL
FOR VOLUNTARY EXECUTION FOLLOWED BY ORGAN DONATION
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/BDP-VX.html
This
essay outlines the likely steps needed
to achieve an execution by means of brain-death
to make it even easier to donate viable organs after death.
THE DEAD-DONOR RULE: HOW DEAD DO YOU HAVE TO BE?
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/CY-DEADD.html
A
prisoner facing execution will only be permitted to donate organs
if the public is completely convinced that the inmate was absolutely
dead
before any organs were harvested.
If you know of others who are thinking along these
lines,
please invite them to visit the article you are reading:
Making Exceptions to the Rules:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/EXCEPT.html
We already have one
prisoner ready and willing to donate organs after
execution.
Who will be the first warden, governor, or transplant doctor
willing to make the necessary exceptions?
If any professional journals would be open to such
thinking,
please suggest them
either by sending this article to the editor of the journal
or writing to the author:
James Park: e-mail: PARKx032@UMN.EDU.
AUTHOR:
James Leonard Park is an existential philosopher and
medical ethicist,
living and writing in Minneapolis, Minnesota, USA.
His interest in prisoner organ-donation
is part of his larger interest in the right-to-die with careful
safeguards.
Much more will be learned about him on his website:
Created
August 5, 2010; Revised 8-6-2010; 8-7-2010; 8-27-2010; 9-30-2010;
10-13-2010;
2-4-2011; 3-3-2011; 4-15-2011; 4-22-2011; 12-10-2011;
4-21-2012;
4-5-2013; 9-7-2013; 10-5-2013; 8-19-2014;
10-27-2015; 9-9-2016;
A
Facebook Page has been created:
Prisoner
Organ Donation.
This
group welcomes participation by anyone interested in organ
donation from prisoners:
prisoners
who have Internet access, family members, friends,
lawyers,
prison authorities, transplant surgeons, medical ethicists,
journalists, & students.
The
above open letter to various people who must approve changes in
procedure
has
now become Chapter 9 of Organ
Donation After
Execution.
This
Internet
Book was discussed chapter-by-chapter
on
this Facebook Page in 2014.
Go to
the beginning of this website
James
Leonard Park—Free
Library