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Transplant-for-freedom case ethical?

JACKSON, Miss. - A debate is unfolding over an unusual offer from Mississippi's governor: He will free two sisters imprisoned for an armed robbery that netted $11, but one woman's release requires her to donate her kidney to the other.

The condition is alarming some experts, who have raised legal and ethical questions. Among them: If it turns out the sisters aren't a good tissue match, does that mean the healthy one goes back to jail? Gov. Haley Barbour's decision to suspend the life sentences of Jamie and Gladys Scott, who are black, was applauded by civil rights organizations and the women's attorney, who have long said the sentences were too harsh for the crime.

The Scotts were convicted in 1994 of leading two men into an ambush in central Mississippi the year before. Three teenagers hit each man in the head with a shotgun and took their wallets - making off with only $11, court records said.

After 16 years in prison, Jamie Scott, 36, is on daily dialysis, which officials say costs the state about $200,000 a year.

Barbour agreed to release her because of her medical condition, but Gladys Scott's release order says one of the conditions she must meet is to donate the kidney within one year.

The idea to donate the kidney was Gladys Scott's and she volunteered to do it in her petition for early release.

Arthur Caplan, the director of the Center for Bioethics at the University of Pennsylvania, has studied transplants and their legal and ethical ramifications for about 25 years. He said he's never heard of anything like this.

Even though Gladys Scott, 38, proposed the idea in her petition for an early release and volunteered to donate the organ, Caplan said, it is against the law to buy and sell organs or to force people to give one up.

"When you volunteer to give a kidney, you're usually free and clear to change your mind right up to the last minute," he said. "When you put a condition on it that you could go back to prison, that's a pretty powerful incentive."

Dr. Michael Shapiro, chief of organ transplants at Hackensack University Medical Center in New Jersey and chairman of the ethics committee at the United Network for Organ Sharing, said the organ transplant may potentially violate the valuable consideration clause" in federal regulations.

That clause is meant to prohibit the buying or selling of organs, and Shapiro said the Scott sisters' situation could violate that rule because it could be construed as trading a thing of value - freedom from prison - for an organ.

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