Ethical flags raised over granting parole for kidney donation

Mississippi Gov. Haley Barbour's decision to commute the prison sentences of two sisters drew wide attention in part because their cause has been embraced by civil-rights activists. But an unusual aspect of the arrangement also is drawing scrutiny: Barbour said his action was "conditioned on" one sister donating a kidney to the other.

The case involves sisters serving double life sentences for convictions in a 1994 armed robbery that netted $11. Barbour, a Republican in his second term, agreed this week to suspend their sentences in light of the poor health of Jamie Scott, 38, who requires regular dialysis, which officials say costs the state about $200,000 a year. The governor said the release of Gladys Scott, 36, is conditioned on her giving a kidney to her inmate sibling.

"The Mississippi Department of Corrections believes the sisters no longer pose a threat to society," Barbour said. "Gladys Scott's release is conditioned on her donating one of her kidneys to her sister, a procedure which should be scheduled with urgency."

Some medical ethicists are concerned about the role of the organ donation in the Scotts' release. Barbour's spokesman Dan Turner said the contingency was Gladys Scott's idea.

"It was something that she offered," Turner said. "It was not held as a quid pro quo. She offered."

Gladys Scott will not be forced to return to prison if she cannot donate the organ for some reason, the governor's office said.

Jamie Scott, who has diabetes and high blood pressure, suffered kidney failure in January 2010. She receives dialysis at least three times a week.

Turner said the sisters are a blood-type match, but that tests to determine tissue compatibility still need to be done.

Medical ethicists say they're concerned, even if the donation is voluntary.

"If the sister belongs in prison, then she should be allowed to donate and return to prison, and if she doesn't belong in prison, then she should have her sentence commuted whether or not she is a donor," said physician Michael Shapiro, chief of organ transplantation at Hackensack University Medical Center in New Jersey and chair of the United Network for Organ Sharing's ethics committee.

NAACP President Benjamin Jealous, who met with Barbour about the sisters' case and has pushed for their release, said the governor's office has made it clear Gladys Scott will not go back to prison if her kidney is not a match. Both sisters will follow traditional parole release procedures.

"This is a shining example of how governors should use their commutation powers," Jealous said. The sisters plan to relocate to Florida, where they have relatives, and future health costs likely would be paid by Medicaid or that state if they do not acquire private insurance. Kidney transplants are part of routine Medicaid coverage.

The release of the Scott sisters, who are black, had become an issue of social justice among civil-rights advocates, who argue they were given an extraordinarily long punishment for the crime. They were convicted of luring two men into an armed robbery that netted $11. Their alleged accomplices, three teenagers who hit each man in the head with a shotgun and took their wallets, have served their sentences and been released.

However, the state parole board previously had denied the Scotts' applications for early release. The governor's office said their applications to him, which mentioned the kidney donation, bolstered their appeal for release.

Shapiro said he fears that, if it becomes widely known that donating an organ could spur release from prison, "everybody in prison would be lining up with the parole board offering to donate a kidney."

Arthur Caplan, the director of the Center for Bioethics at the University of Pennsylvania, has studied transplants and their legal and ethical ramifications for about 25 years. He said he's never heard of anything like this.

Even though Gladys Scott proposed the idea in her petition for an early release and volunteered to donate the organ, Caplan said, it is against the law to buy and sell organs or to force people to give one up.

"When you volunteer to give a kidney, you're usually free and clear to change your mind right up to the last minute," he said.

He also said inmates often are not in the best physical shape because of communicable diseases, poor diet and other issues related to health. All those factors contribute to a person's readiness for organ donation.

The United Network for Organ Sharing's ethics committee has struggled with the question of whether inmates should be permitted to donate organs, fearing they could be forced to make such decisions under duress. Ethicists generally agree that the donations can be made if they are under certain circumstances, such as donating to a close relative.

The Scott sisters' attorney, Chokwe Lumumba, said people have asked if Barbour, who is mentioned as a potential presidential contender in 2012, suspended their sentences for political reasons.

"My guess is he did," Lumumba said, but he said the governor did the right thing.

Material from The Associated Press and The New York Times is included in this report.