Doctors routinely ask would-be donors about their health, well-being, and ability to look after themselves and whether they smoke or take recreational drugs. These factors will affect not only whether their organs are suitable for donation but how likely they are to recover well from the procedure.
“I would be worried that someone who is incarcerated might not feel comfortable giving me a full, transparent history,” says Reese. “It is difficult to assess someone’s lifestyle when they’re incarcerated and they can’t actually make decisions freely.”
There are other problems with the bill. Its apparent goal is to increase living organ donation from people who are in prison. We know full well that these people are a vulnerable group, much more likely to have been born into poverty or subjected to childhood abuse, for example. We also know that ethnic and racial minorities are overrepresented in prison populations. Just over 30% of US inmates are Hispanic, for example, and 38% are Black.
“It could be perceived … as harvesting organs from Black [people] to give to others,” says Bell. “There could be a question of exploitation.”
State Representative Carlos González, who is one of the bill’s cosponsors, sent me a statement arguing that “broadening the pool of potential donors is an effective way to increase the likelihood of Black and Latino family members and friends receiving life-saving treatment.”
It is true that people from racial and ethnic minority groups have an even harder time getting the organs they need. In 2020, for example, the number of transplants performed on white people was 47.6% of the number currently waiting. The figure was only 27.7% for Black people. But there are other ways to inform minority communities about organ donation and encourage informed decisions about it. And they shouldn’t involve trading organs for freedom.
Which brings us back to the first point. How much are our organs worth, and how is that decision made? Is a kidney worth a year of freedom? Is bone marrow worth less? “How do they decide the calculus here?” Bell wonders. “Is it really a fair exchange?”
Thankfully, even if the bill were to pass, it wouldn’t mean that such trades would ever take place. Every organ donation has to be approved by a medical and ethics team, which includes a person whose sole function is to advocate for the donor. It’s unlikely that everyone would be comfortable with this type of exchange, says Reese. I think that’s probably for the best.