Doctors regularly ask potential donors about their health, well-being and ability to care for themselves, as well as whether they smoke or take recreational drugs. These factors will affect not only whether their organs are suitable for donation, but also how likely they are to recover well after the procedure.

“I would be terrified that an incarcerated person might feel uncomfortable giving me a full, transparent story,” Reese says. “It’s hard to assess a person’s lifestyle when they’re incarcerated and can’t make decisions freely.”

There are other problems with the bill. Its apparent goal is to increase living organ donation from people in prison. We know very well that these people are a vulnerable group, much more likely to have been born into poverty or to have been abused as children, for example. We also know that ethnic and racial minorities are over-represented in the prison population. For example, just over 30% of US prison inmates are Hispanic, and 38% are black.

“It could be seen… as harvesting Black’s organs [people] to give to others,” Bell says. “There may be a question of exploitation.”

State Representative Carlos Gonzalez, who co-sponsored the bill, sent me a statement saying that “expanding the pool of potential donors is an effective way to increase the likelihood that black and Latino family members and friends will receive life-saving treatment “.

Indeed, it is even more difficult for people from racial and ethnic minorities to get the organs they need. For example, in 2020, the number of transplants given to white people was 47.6% of the number currently waiting. For blacks, this figure was only 27.7%. But there are other ways to inform minority communities about organ donation and encourage them to make informed decisions about it. And they shouldn’t be trading organs for freedom.

Which brings us back to the first point. How much do our organs cost and how is this decision made? Is a kidney worth a year of freedom? Does bone marrow cost less? “How do they settle the score here?” Bell wonders. “Is this really a fair exchange?”

Fortunately, even if the bill passes, it won’t mean that such bidding will ever happen. Every organ donation must be approved by a medical and ethics panel, which includes a person whose sole function is to protect the donor. Not everyone is comfortable with this type of exchange, Reese says. I think it’s probably for the best.

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