Prison Status and Organ Allocation

Recent news coverage of a prison inmate in California receiving a heart transplant has sparked interest across the country. The United Network for Organ Sharing feels that some clarification on how the nation’s organ sharing system works would be helpful.

• The United Network for Organ Sharing (UNOS) coordinates the nation’s Organ Procurement and Transplantation Network (OPTN) under contract with the US Department of Health and Human Service.
  
  
• The OPTN was created in 1986 under the auspices of the National Organ Transplant Act (NOTA). NOTA is a federal law, which outlawed the sale of human organs. It also specifies that the OPTN establish medical criteria for organ allocation. Medical criteria for organ allocation include compatibility of the donor and the recipient and medical urgency.
  
  
• Social criteria such as celebrity status, wealth, or prison status, are excluded from medical criteria and therefore are not permitted in consideration of organ allocation. Federal law permits use of medical criteria, not social criteria in organ allocation policies.
  
  
• The transplant community allows the evaluation of prisoners for transplant candidacy because prison status is a social worth distinction, not related to medical treatment of disease. Based on medical criteria, transplant programs decide whether to accept any individual patient for treatment. The evaluation does not include social criteria such as criminal or prison status, employment or wealth. It does include the likelihood of survival and of patient compliance with long term medication requirements to prevent rejection.
  
  
• Being listed on the UNOS national patient waiting list for organ transplant does not guarantee any candidate an organ.
  
  
• The OPTN/UNOS Ethics Committee is on record as saying that criminal or prison status, in and of itself, should not restrict consideration of a potential transplant candidate. Prison status is most often temporary. Most prisoners eventually get out of jail through due process. A decision to provide or withhold lifesaving medical treatment for a prisoner is permanent and may not come under any due process. Click here to view the Ethics Committee statement regarding convicted criminals and transplant evaluation.