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Prisoner’s dilemma: kidney donation

Posted Jan 06 2011 3:38pm

In A Modest Proposal on Kidney Donation , psychiatrist and kidney recipient Sally Satel and Ira Brody suggest providing compensation for prisoners who donate their kidney after serving their sentence. This suggestion grows out of a much-criticized suspension of two sisters’ life sentences in Mississippi conditional on one donating a kidney to the other.

Satel and Brody’s proposal, as printed in the Wall Street Journal, is as follows:

  • Prisoner donates a kidney and gets paid once his/her sentence is complete
  • Prisoner is told there is “no bearing on parole, thus neutralizing the concern that an inmate is relinquishing an organ to secure his or her release”
  • Donor undergoes rigorous informed consent and has a “cooling off” period before proceeding
  • Upon completion, donor gets $40,000 in an account managed by a “state-approved agency” and distributed as an annuity upon release

This proposal probably would increase the number of kidneys made available for donation and reduce government dialysis expenses, but the proponents are naive in thinking it wouldn’t be coercive. The big issue is the second point –the idea that there would be no bearing on the patient’s parole. That seems especially unlikely. I’m sure that the prisoner would have some expectation that it would help and that even if the donation wasn’t explicitly mentioned it would factor in during the parole board hearing when information was presented on how the prisoner had changed … and also on the state of his health with just one kidney.

I don’t see why this program should have anything to do with prisoners. Either make it available to everyone or exclude prisoners, since it is likely to be coercive.


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