Conditional Freedom

Gladys Scott wanted to donate a kidney to her sister Jamie who has been on dialysis and not doing well. The two sisters have been in prison for 16 years for their part in a robbery.

Having worked with patients whose kidneys failed due to inadequate treatment for their diabetes, I wonder if Jamie’s life-threatening illness could have been prevented with low-tech, basic care. Scratch that– I’m certain that she would not be on dialysis if her diabetes had been treated properly.

Barbour said in a statement. “The Mississippi Department of Corrections believes the sisters no longer pose a threat to society. Their incarceration is no longer necessary for public safety or rehabilitation, and Jamie Scott’s medical condition creates a substantial cost to the State of Mississippi.”

What will Jamie Scott do for medical care? Sixteen years of her life gone and no safety net.

Having read some details of the legal case, I wonder why they were given such a long sentence.

Here’s a link to a site called Free the Scott Sisters.

Here’s Bob Herbert– on the ethics of requiring an organ donation as a condition of release.

As Bob Herbert notes– Gladys had long wanted to donate a kidney to her sister, but was ignored. Making a ‘condition’ of what she was going to do out of family love throws a moral dilemma into the situation unnecessarily.

I hope this story won’t disappear after the sisters are released. I want to know what happens to them, and wish them better health in 2011.

I have to go to work now, but I want to re-run a story from 2007, about commodification of the body—

Desperately Selling a Kidney

It was a strange experience reading Sally Satel’s essay, Desperately Seeking a Kidney in last Sunday’s New York Times. The writer, a resident scholar at the conservative think tank, American Enterprise Institute, needed a kidney transplant. She offers her personal narrative, and then some proposals for inducing the poor to sell their bodies in a free market.

Ms. Satel begins with her experience as a woman suddenly faced with a life-threatening illness…

Three days a week, for four debilitating hours at a time, I would be tethered to a blood-cleansing machine. Even simple things like traveling to see friends or to give talks would be limited. This would very likely continue for at least five years until my name crawled to the top of the national list of people waiting for kidneys from the newly deceased. On average, 12 names, the death toll from the ever-growing organ shortage, would be scratched off the list each day.

She is a psychiatrist, working in a methadone clinic, and she knew from her medical training what dialysis involves. She dreaded it so much that she chose not to wait on the transplant list, opting instead to search for a live donor. She writes honestly and unsparingly of her failed negotiations with two friends, then with a man she met online. Finally she received an offer from an acquaintance, Virginia Postrel, a fellow conservative writer, and the transplant was successful.

While Ms. Satel calls the gift she received, ‘altruism’ she has a different definition when applied to people outside her circle.

We must be bold and experiment with offering prospective donors other incentives for giving, not necessarily payment but material reward of some kind– perhaps something as simple as offering donors lifelong Medicare coverage. Or maybe Congress should grant waivers so that states can implement their own creative ways of giving something to donors: tax credits, tuition vouchers or a contribution to a giver’s retirement account.

This is the kinder, gentler version. She is not ignorant of how desperate things can get for the poor in this world…

I flirted with the idea of becoming a ‘transplant tourist’ in Turkey or the Philippines, where I could buy a kidney. Or going to China, where I would have to face the frightful knowledge that my kidney would probably come from an executed prisoner. Grim choices, but I was afraid I could die on dialysis if I didn’t do something to save myself.

In all of this long essay Ms. Satel never wonders what would have happened if she were poor and uninsured. She seems to live in a bubble where the only problem is a lack of donated organs. And she downplays, almost callously, the risk to the donor.

The operation is done by laparoscope, leaving only a modest three-inch scar. She would have been out of the hospital after two or three nights. Most important, the chance of death is tiny–2 in every 10,000 transplants– and the long-term health risks are generally negligible.

This kind of reasoning explains a lot about why conservatives can be persuaded that whatever works for them is just peachy. There is a reason nature gave us two kidneys, a woman with chronic renal failure should be able to figure that out. If you lose one, as did my aunt, to a tumor, or my friend, to a motorcycle accident, you have a spare. And I’m not so casual about the long-term health risks — we haven’t been doing these transplants for all that long. Not to mention the risk of post-surgical infection as antibiotic resistant germs increase. Myself, I would gladly take this risk for love, but god grant I never have to for money.

But back to the kinder, gentler. The mother who sells a kidney so her son can go to college ( no pressure, Sonny), or the eighteen year old who needs cash and feels invincible. Or the man who needs insurance and can’t get accepted on an affordable plan. David Holcberg, of the Ayn Rand Institute puts it a little more frankly. This was printed on the Journal’s editorial page –

A person may reasonably decide, after considering all the relevant facts (including the pain, risk and inconvenience of surgery), that selling an organ is actually in his own best interest. A father, for example, may decide that one of his kidneys is worth selling to pay for the best medical treatment available for his child…

Opponents of a free market in organs argue as well that it would benefit only those who could afford to pay–not necessarily those in most desperate need. This objection should also be rejected. Need does not give anyone the right to damage the lives of other people, by prohibiting a seller from getting the best price for his organ, or a buyer from purchasing an organ to further his life. Those who can afford to buy organs would benefit at no one’s expense but their own. Those unable to pay would still be able to rely on charity, as they do today. And a free market would enhance the ability of charitable organizations to procure organs for them.

Just think, all those deadbeats sitting in the waiting room at Hasbro with their sick kids, they could be persuaded to put out if they want ‘the best medical treatment for their sick child’.

But don’t consider giving free medical care to needy children, or scholarships to hardworking poor students. That would be immoral.

We are really on the edge of a class disparity that is not only about money but blood. We already pay lip service to ‘serving our country’ while dangling cash and scholarships in front of the kids at Central and Hope High. The recruiters know where to go.

No matter how well written, and no matter how much natural sympathy one feels for anyone who goes through a dangerous illness, Sally Satel’s essay is horrible. In countries where desperate people sell their kidneys, you can be sure there will be many who die prematurely when their remaining kidney gives out, and there will be no help for them. I wonder where in the Libertarian scheme of things you put the person who sold a kidney, and now needs one. Do you chalk it up to ‘bad choices’ ? We will be going down a very dark road if we give up the principle of taking care of our own, rich or poor, and instead let the rich use the poor for spare parts.

For another, less temperate, take on this, check out Daily Kos. And yes, I’ve signed a donor card, but they’re not getting them until I’m dead.

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8 responses

  1. I can’t donate organs because of medical history-I would like to have had the option,but they can’t use any of them.
    I agree that poor children should have free care.If one is pro-life,like myself,it would be immoral to forget about children once they’re out of the womb.It’s a good use of my taxes.
    On the other hand,I could care less about people who are in prison for crimes like armed robbery-there are many desperately poor people who’d never consider such a crime.
    I guess the only people you are devoid of sympathy for are Sarah Palin and her family and anyone associated with Fox News.
    If you are a junkie and ruined your health so you could get high,that’s your problem.
    It’s disingenuous to mix innocent children(no kid is responsible for the conditions they are born into)with lowlife criminals.I don’t want to hear excuses why people are in the can.Have you been convicted of a crime?I highly doubt it since you have a nursing license.(By crime I mean something serious)I haven’t.
    You can’t emote over everyone.
    I wish birth control got more emphasis and then we wouldn’t be fighting over abortion.Or not as much,anyway.

  2. I actually advocate for children’s health. Trig Palin will still deserve support after he turns 18. He has a rich family, his mother seems determined to remove the safety net for children who are not so lucky. I’m hard on his mother, but she did run for Vice President and is now on the lecture circuit. She keeps saying things and she seems to like attention.
    Prisoners don’t lose their human rights when they are incarcerated. There are a lot of good nurses working at the ACI, I went to school with a few.
    Not everyone who is convicted is guilty. Do you really want to impose a death sentence by neglect, when the crime might be minor or nonexistent?
    Take a look at the people who want to restrict access to birth control. Most of them are doing it in the name of ‘pro-life’. I wish people who feel as you do would talk to them. I’ve tried.

    1. Most people in prison are guilty.You are a nurse and I respect that-I spent 27 years hands on in the criminal justice system,so have some for my opinion-it isn’t based on talk radio or cable pundits.
      BTW a lot of people say things and make money-they also write books and make money.
      It’s not like Sarah Palin is forced on people-if she didn’t have an audience and followers she wouldn’t make money.
      She’s good at getting people energized,like those “motvational speakers”who are ubiquitous these days.I’d sooner drink snot than listen to one of them,but,heck,it’s a free country.There are times when I get the idea that you and Kiersten would like for only “appropriate”speech to be allowed on the airwaves and tv.I’m not sure,but it seems that way occasionally.
      I’d be happy if Fred Phelps took a stroke and died the next time he defiled a military funeral,but the courts have said he’s entitled to do that.I guess short of threats and advocating murder,we have to live with whatever people say.It can be unpleasant,but life in a free country is a crap shoot.
      Here’s my way of thinking-if there is a finite amount of medical care available,and the choice is between a child and a convict,the convict doesn’t get it.
      Nor should I-I’m in my 60′s and I wouldn’t step in line ahead of a kid,even if it meant my death,and I’ve been close enough a few times that I’m not just shooting off my mouth here.
      And another thing-people who aren’t in prison but who are disabled through no fault of their own should get priority.
      Jimmy Carter was the worst President in my lifetime-some of our major problems today can be laid at his feet-Iran,Afghanistan,and immigration chaos to name just three.
      The presidents following,including Barack Obama,have tried to play pick up sticks with his blunders and their aftermaths.Not very sucessfully either.
      Jimmy Carter is on the lecture circuit,writes books,and unlike Sarah Palin,actually meddles in foreign elections and US foreign policy.
      Does that bother you in the least?

  3. Oh,one more thing-get a lunch box for those GA hearings because I think they will be more contentious than ever this year,what with same sex marriage,tax on food and clothing,e-Verify,in state tuition for illegal aliens,and voter ID.Everyone waiting to testify will wish they were waiting for a flight at LaGuardia in a snowstorm.

  4. There’s moral reasons to ensure that people in the custody of the state get their basic needs met, but I’ll give you a practical one–
    Prisoners get released.
    It’s better if they come out in decent health with some kind of job counseling than to make their next stop at the emergency room and a few weeks at RIH. Prevention is cheaper, and we’re not yet the kind of society that officially tells people to just lie down and die.

    1. Prisoners get released.Yes,like the animal serving three life sentences who gunned down a Woburn police officer during a robbery because they paroled him!!Thank God he was also killed-no trial for the family to endure.
      I was almost killed by a guy out on bail for murder who had 6 or 7 convictions for assault.he executed a man on Pocasset Avenue and three weeks later tried to run myself and another officer over when we were attempting to serve a search warrant.
      ah plead out to homicide,ADW(2 counts),and drug possession and got 10 years-he was paroled in 7 years and a few weeks later murdered his former wife and committed suicide.Nice,all this good rehab that goes on in prison.Some people are just destructive,anti-social organisms who should never see daylight again.
      There are SOME people who commit homicides who can eventually return to society,but not many.Armed robbers are even worse risks to re-offend,like sexual predators.

  5. observer:

    I love your comment:

    “Everyone waiting to testify will wish they were waiting for a flight at LaGuardia in a snowstorm.”

    It’s been a few years, but I remember nearly melting once when waiting to testify.

    1. What I remember the most is waiting three hours in the Judiciary Committee of the House to testify against a few bills submitted by David Segal which I thought were really foolish and anyway,that’s not the point.
      They asked people to speak for only three minutes-some former minister who was defending illegal aliens rambled on for about twelve minutes and then then,when I stepped up to testify,Williamson put on his egg timer and I got cut off right at 3 minutes.Unlike Christopher Young,I didn’t make a scene,but the miserable and unfair attitude displayed by the Reps made me certain never to testify there again.
      I had a completely different impression of the Senate Judiciary-reasonable time to testify and generally non-arrogant behavior by the Senators(except Levesque).
      Rhoda Perry was livid when I testified against her bill,preseenting concrete facts which she couldn’t dispute.She declined to question me,because on that particular subject she knew I owned her.The bill was voted down in committee.
      BTW so was Segal’s.
      Now I don’t care if you’re liberal or conservative-if a time limit is set,it should apply across the board.
      The Chris and Kara Show gets annoypng when they refuse to recognize that others are waiting.
      I remember David St.Germaine liked to go on at length,but he was willing to be last,which was ok with me because he was only taking the legislators’ time and they get paid for that.

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