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'Conditioned on' kidney donation, sisters' prison release prompts ethics debate

By Krissah Thompson
Washington Post Staff Writer
Thursday, December 30, 2010; 7:46 PM

Mississippi Gov. Haley Barbour (R) has announced that he will grant an early release from prison to two sisters serving unusually long sentences for armed robbery.

Gladys and Jamie Scott have each served 16 years of life sentences. Their case had become a cause celebre among civil rights groups, including the NAACP, which mounted a national campaign to free the women.

Civil rights activists said Thursday that they welcome Barbour's decision. But an unconventional aspect of the arrangement is drawing scrutiny from medical ethicists: Barbour said his action was "conditioned on" one sister donating a kidney to the other.

Barbour agreed this week to suspend their sentences in light of the poor health of Jamie Scott, 38, who requires regular dialysis. The governor said in a statement that 36-year-old Gladys Scott's release 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 in the statement. "Their incarceration is no longer necessary for public safety or rehabilitation, and Jamie Scott's medical condition creates a substantial cost to the State of Mississippi. . . . Gladys Scott's release is conditioned on her donating one of her kidneys to her sister, a procedure which should be scheduled with urgency."

The sisters were convicted of luring two men into an armed robbery that netted $11. Their three teenage accomplices, who hit each man in the head with a shotgun and took their wallets, have served their sentences and been released.

The national and Mississippi NAACP had been working for much of the year to win the release of the Scotts, who would have come up for parole in 2014. Barbour, who is weighing a run for president, announced his decision a week after he ran afoul of civil rights advocates.

The governor had told the Weekly Standard that he didn't remember the time of the civil rights movement "being that bad" and spoke benignly of the white Citizens Council in his home town. Last week, Barbour backtracked on the comments, condemning such groups and policies.

While Barbour's decision in the Scotts' case was lauded by the NAACP, some medical ethicists say they are concerned about the role of the organ donation in the release. Barbour's spokesman Dan Turner said the contingency was Gladys Scott's idea.

"It was something that she offered," he said. "It was not something that the governor's office or Department of Corrections or the parole board said, 'If you do this, we would do this.' It was not held as a quid pro quo. She offered."

The medical ethicists say they're still 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 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, 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," he said. "At the end of the day, the most important thing is that they are free and reunited with their families."

The sisters are a blood-type match, but it's not yet known whether they are a tissue match. They plan to relocate to Florida, where they have relatives, and future health costs would probably be paid by Medicaid or that state if they do not acquire private insurance. Kidney transplants are routinely covered by Medicaid.

The state parole board had previously denied the Scotts' applications for early release. The governor's office said their applications to him, which reached him on Christmas Day and 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."

Medical ethicists and physicians around the country have been debating the situation among themselves on e-mail group lists and in conversations, said Arthur Caplan, chair of the department of medical ethics at the University of Pennsylvania.

He said Barbour's decision potentially interferes with sound medical judgment. Inmates are often not in the best physical shape because of communicable diseases, poor diet and other issues related to health, Caplan said. All of those factors contribute to a person's readiness for organ donation.

"In our system of getting kidneys from living people we would never coerce them by saying we hope you do this or else," Caplan said. "You're in a weird situation where the governor is meddling a little bit into what is basically a medical decision first."

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