Interesting ethical conundrum

[']['ear]

this one lies closer to home than most, which caught my attention.

Jailed Sisters Released for Organ Transplant
By TIMOTHY WILLIAMS
Published: January 7, 2011

Two Mississippi sisters who have been imprisoned for 16 years were released on Friday morning on the condition that the younger sibling donate a kidney to her older sister, whose organs are failing.

Jamie and Gladys Scott walked out of the Central Mississippi Correctional Facility in Pearl, Miss. at just after 8 a.m. Central time Friday morning, and were greeted by their mother, their children and throngs of reporters.

The case of the Scott sisters attracted widespread attention after Gov. Haley Barbour suspended their double life sentences last month with the stipulation that Gladys Scott, 36, give one of her kidneys to Jamie Scott, 38.

The kidney donation was the sisters’ idea, and is supported by the N.A.A.C.P. and other civil rights organizations. But the unusual nature of the arrangement has been criticized by some medical ethicists.

Legal experts said that suspending a prison sentence contingent on an organ donation is highly unusual and may be unprecedented.

Jamie Scott requires dialysis treatment at least three times a week, and her health has been failing during the past few months.

The women plan to live in Pensacola, Fla., with their mother and their children. Jamie Scott has three children; Gladys Scott has two.

The Scotts were arrested on Christmas Eve 1993, when Jamie was 21 and Gladys 19, and they were convicted the following year on charges that they led two men into an ambush, during which the men were robbed of about $11, according to the trial transcript.

Three boys, aged 14 to 18 at the time, were also convicted in the case; they served their sentences and were released from custody years ago, Mississippi officials said. The sisters have denied playing any role in the crime.

After years of unsuccessful efforts by their family and friends to get the sisters released based on inconsistencies in testimony during the trial, Jamie Scott’s kidney failure last year led to a new grassroots campaign to free them. The effort on behalf of the sisters, who are black, was taken up by African American-themed Internet sites, by the N.A.A.C.P. and by African American politicians in Mississippi.

After mulling over the matter for several months, Gov. Barbour announced in late December that he would not pardon the sisters, but would instead indefinitely suspend their sentences.

Gov. Barbour said he had acted in part out of concern over Jamie Scott’s health, but also to relieve the state of the cost of her dialysis treatment, approximately $200,000 a year.

“The Mississippi Department of Corrections believes the sisters no longer pose a threat to society,” Mr. Barbour said in a Dec. 29 statement. “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.”

The sisters will be on parole for the rest of their lives, the sisters’ attorneys said.

Many questions remain unanswered, including who will pay for the kidney transplant operation. The sisters’ advocates say the family cannot afford the procedure on their own and that it is unclear whether they will qualify for Medicaid.

Hmm, a number of ethical conundrums here.
1) Western Medical ethics has clearly established that there should be no quid pro quo in live organ donation, yet here we have release contingent on donation.
2) To what degree should government provide health care to inmates? After all, government still doesn't provide health care to many who can't afford health care. So if you're poor, you'll get basics covered better if you go to prison? Some of you may recall that I questioned the expense for my own transplant, ad I'm a law-abiding and contributing member of society.
3) Related, what is reasonable health care? I've long thought that there's a difference between general health care and the 200K/year of dialysis. We seem to have an all or nothing mentality, and I'm not sure that's appropriate.
4) What about self-inflicted health catastrophes? Just a guess here, but Jamie Scott looks morbidly obese, and I'm guessing that her kidney failure is due to diabetes (and btw it's damned hard to be fat while on dialysis, unless she doesn't adhere to her dietary restrictions). If you eat yourself into a grave, should society pay for the hideously expensive process? {Again, not claiming to be objective here: a) I resent that people who have abused their bodies and neglected their health extend kidney wait lists by decades in front of people who treat their body like a temple, like myself, and b) I know that transplant list priorities are made in part by the prognosis and outcome (age, health history, cause of failure). Yet here we have an inmate who is likely to have abused/neglected herself into organ failure (an assumption, granted, but let's work with it)}
5) Why is race brought into this? Why is the NAACP involved?

There are other issues as well, but this is good starting material.

[LittleFuzzy]

5) Why is race brought into this? Why is the NAACP involved?

They were serving double life sentences in Florida for an assault and robbery.

[Khendraja'aro]

They were serving double life sentences in Florida for an assault and robbery.

"Only" armed robbery, Fuzzy. Not to mention that the two guys they robbed were not harmed in any way. I fail to see why that constitutes a double life sentence for each. Shouldn't those be reserved for the most heineous of crimes?

[Crowheart]

^ ^Mississippi.

On the face of it, their sentence seems absurd.
The whole story gives a vibe that this is all about justifying releasing them, and the organ donation is just the loophole they are using.

[']['ear]

Overly severe sentencing? OK, I get it.

What about the rest?

I'll add a tidbit that most are probably not aware of. Medicare actually pays for the kidney transplant and first three years of treatment (yes, at age 42 I am on medicare, at least until January 2012). Just kidneys. An odd consequence of this is that some uninsured people get transplants, but can't afford the medications after medicare cuts out, and the lose their kidney.

And as you can see dialysis costs much more, with lower functionality.

[Omega]

200k a year? holy shit cakes. there have been stories of men committing minor crimes in order to be found guilty of misdemeanors because they wanted three meals a day and a roof, but this is a flabbergasting amount.

[GGT]

Overly severe sentencing? OK, I get it.

What about the rest?

I'll add a tidbit that most are probably not aware of. Medicare actually pays for the kidney transplant and first three years of treatment (yes, at age 42 I am on medicare, at least until January 2012). Just kidneys. An odd consequence of this is that some uninsured people get transplants, but can't afford the medications after medicare cuts out, and the lose their kidney.

And as you can see dialysis costs much more, with lower functionality.

But now the state of Mississippi has to pay all the costs of the transplant, and subsequent medications and therapies. For both sisters. Because it's court ordered.