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Are Prisoners Medical Captives?

By Darlyn Pirakitikulr and Harold J. Bursztajn
July 28, 2005

The medical treatment of captive patients is a litmus test for a good society. See Bursztajn HJ, Brodsky A: Captive Patients, Captive Doctors: Clinical Dilemmas and Interventions in Caring for Patients in Managed Health Care. Gen. Hospital Psychiatry 1999; 21:239-248; and Bursztajn HJ, Brodsky A: Clear, Convincing, and Authentic Advance Directives in the Context Of Managed Care? J. Clin Ethics 1994; 5:364-366. If those such as prison inmates, the poor, or patients in restrictive managed care plans who have little choice as to their treating clinician are nonetheless able to rely on their physicians for ethical treatment, then those who do have a choice can do so all the more. Bursztajn HJ, Feinbloom RI, Hamm RM, Brodsky A: Medical Choices, Medical Chances: How Patients, Families, and Physicians Can Cope with Uncertainty. New York: Routledge, 1990. In total-institution settings, demoralization sets in when what little choice remains is further restricted.

It is against this background that the question of whether prisoners should be allowed to donate organs for transplantation is explored. In this article, we focus on prospective living organ donors who face capital punishment. Some of the issues raised may also apply to death row inmates who wish to become cadaveric organ donors and donate their organs after death. However, in the latter instance, their right to do so may conflict less with society's interest in justice.

Background

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