OPTN/UNOS perspectives on organ recovery from condemned prisoners

UNOS | Anne Paschke
Dear friends,

For the past few days, the story of a prisoner on death row who wants to become an organ donor has garnered a good deal of media attention. Media interest is growing, now that the Governor of Ohio has granted a stay of execution “so that medical experts can assess whether or not Phillips’ non-vital organs or tissues can be donated to his mother or possibly others.”

Here is the statement that UNOS is providing to the media regarding condemned prisoners as organ donors. It is also on our website.

OPTN/UNOS perspectives on organ recovery from condemned prisoners
There have been several instances in the United States within the last 20 years where condemned prisoners have requested to become organ donors, either upon their execution as a deceased donor or prior to execution as a living donor. Ultimately the correctional authority must decide whether to allow any inmate to be evaluated for donation, and an organ procurement organization and/or transplant center must make medical decisions whether to accept any person as a donor and allow a transplant to proceed.

Since 1998, the OPTN/UNOS Ethics Committee and Board of Directors have stated and reaffirmed fundamental opposition to the transplantation of organs from prisoners upon execution. The OPTN/UNOS Board, in a 2007 resolution, deemed this practice “morally reprehensible.”

Everyone understands and agrees with the fundamental need for more organ donors to help candidates urgently awaiting a transplant. There are, however, ethical concerns and the potential for unintended consequences if organs were to be recovered upon execution.

The Ethics Committee observes the extreme difficulty in ensuring that a condemned prisoner could give proper informed consent for donation, free from any coercion or consideration of personal gain. Public trust in the system of organ transplantation is based on the rights of everyone to make a free and fair choice regarding donation. If that choice is limited for some, due to concerns regarding coercion, public trust may be undermined.

The OPTN/UNOS Ethics Committee and Board of Directors have recognized, in very limited circumstances, the potential for prisoners to become living organ donors while incarcerated. OPTN policies require transplant programs to appoint, for all potential living donors, an independent donor advocate to ensure they are fully informed and can properly consent to donation. Transplant hospitals must comply with all OPTN obligations for every living donor recovery and transplant.

Prisoners present special concerns and vulnerabilities, and appropriate precautions are necessary to prevent the potential for coercion. Additional considerations may include security requirements for the prisoner and a potentially higher risk of disease transmission to the recipient as compared to a donor from the general population. While neither the Ethics Committee nor the Board of Directors specifically studied the application of these special concerns to potential living donations from condemned inmates, significant concerns remain with any consideration of organ recovery from condemned prisoners.

In case you’re wondering, there has never been a case in the United States of an executed prisoner becoming an organ donor. There was, however, one case we know of where a death row inmate became a living kidney donor for a relative.

Anne Paschke
Media Relations Specialist

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