California Case Highlights ‘Soaring’ Costs in Prison Health Care

A California inmate who received a heart transplant earlier this month represents a "sign" of the "soaring" prison health care costs that "many states may soon face," the New York Times reports. The unnamed 31-year-old inmate, serving a 14-year sentence for a 1996 robbery in Los Angeles, received a new heart in an operation at Stanford University Medical Center on Jan. 3. Although the heart transplant cost "a little more than $200,000," the "total medical costs," including subsequent care, could reach $1 million, California officials said. According to the New York Times, the nation has an aging prison population, and many inmates have chronic conditions that require "expensive treatments," such as organ transplants, which would "add substantially to the tax burden." Under a 1976 Supreme Court decision, states must provide inmates with "adequate medical care." Since the court issued the decision, the Times reports that "many states have been sued" to ensure that inmates received "proper treatment," and state lawmakers have said that they have "no choice but to pay" for prison health care services. Scott Chavez, vice president of the National Commission on Correctional Health Care, said, "This is a responsibility that society has, and the costs can be quite high. Nobody has a real handle on this" (Sterngold, New York Times, 1/31).

However, in a San Jose Mercury News opinion piece, David Perry, director of ethics programs at the Markkula Center for Applied Ethics, writes that most "people would no doubt find it troubling that a criminal would get a major organ transplant while hundreds of law-abiding citizens who desperately need that organ are made to wait." He also questions whether the Supreme Court "intended to give violent criminals a claim equal to that of the rest of us on highly scarce medical resources" such as organs, "especially when the decision to save one person's life with an organ transplant almost inevitably means that someone else will die." Although he says that he "can imagine situations where denying basic medical care to a prisoner would indeed be cruel and unjust," Perry writes that the "unprecedented decision" of the California Department of Corrections to provide an inmate convicted of robbery -- which "implies at least the threat of injury or death to its victims" -- a heart transplant "showed questionable legal judgment." He adds that patients should receive organs based not only on "degree of need" and "probability that the transplant will be successful," but also on whether they have a "history of violent crime." According to Perry, "I think we can agree that if we knowingly commit such crimes and thus violate others' basic rights not to be harmed or killed, we lose the right to an organ transplant when it could save the life of an innocent person." He concludes, "In my view, those who deliberately threaten the lives of innocent persons thereby forfeit whatever moral claim they otherwise might have had to an organ transplant" (Perry, San Jose Mercury News, 1/31).