Mass. bill allows inmates to swap organs for less prison time. Ethics experts say it's exploitative.

The new bill would allow incarcerated individuals the option of donating their organs or bone marrow in exchange for a reduction in their sentence.

Side-by-side images of hands reaching through jail-cell bars clasped and a gloved hand in a hospital setting picking up medical instruments.
Photo illustration: Yahoo News; photos: Getty Images

A new bill proposed in Massachusetts would allow incarcerated individuals the option of donating their organs or bone marrow in exchange for a reduction in their sentences. The bill's authors believe the move will expand the state’s pool of donors and “restore bodily autonomy” to inmates, but ethics experts say it’s potentially exploitative and may also be illegal.

“I don’t see an ethical justification for the proposed Massachusetts law,” John Hooker, an ethics professor at Carnegie Mellon University, told Yahoo News. “If it is OK to release prisoners early due to organ donation, they should be released early without the donation.”

According to Brandon Paradise, a law professor at Rutgers Law School with a focus on legal and personal ethics, “If the bill were to become law, a court may well strike it down.”

Bill HD.3822, which would establish a “Bone Marrow and Organ Donation Program,” was introduced late last month by state Reps. Carlos González and Judith García, both Democrats. If successful, it would allow those incarcerated in the Massachusetts Department of Correction (DOC) to get their sentence reduced anywhere between 60 days and 12 months in exchange for their bodily offering, which may include a liver or kidney, among other vital body parts.

Three health care workers in blue scrubs and face masks are seen behind surgical tools as they focus on something out of view.
Kidney transplant. (BSIP/Universal Images Group via Getty Images)

Proponents of the bill say the program could be a game changer by helping to close the gap of roughly 4,000 Massachusetts residents waiting for organ donors in a region that remains without an adequate pathway to facilitate such a transaction.

González told that he was inspired in part by a close friend awaiting a kidney transplant who requires dialysis multiple times a week.

“I love my friend and I’m praying through this legislation that we can extend the chances of life for him and any other person in a similar life-or-death situation,” he told the outlet.

But critics say that tying an incentive to such a serious decision puts unfair pressure on an already vulnerable population.

“I think this is, frankly, a disaster,” Professor Nicholas Evans, an expert in public health ethics at UMass Lowell, told Yahoo News, noting that the U.S. doesn’t allow prisoners to enroll in clinical studies “because it constitutes a form of undue inducement” and saying this poses the same issue.

“Organ donation needs to be purely voluntary,” Danielle Allen, the director of Harvard’s Edmond & Lily Safra Center for Ethics and a former Massachusetts gubernatorial candidate, told Yahoo News in an email. “This is impossible in a context of a tie to punitive sanctions and the ability to impact them via a donation. The filers of the bill should be encouraged to withdraw it, and it should otherwise be strenuously opposed.”

Of the roughly 10,000 people in DOC prisons in Massachusetts, Black people make up 28% of those incarcerated and Latino people make up 29%, but those groups make up just 9% and 13% of the state’s population, respectively.

Sign in front of large brick compound surrounded by razor wire reading: Commonwealth of Massachusetts Department of Correction Treatment Center
Massachusetts Department of Correction Treatment Center in Boston. (Blake Nissen for the Boston Globe via Getty Images)

According to Paradise, the bill “threatens to exacerbate the problem of racial injustice and inequality in the administration of criminal law.”

Even state Rep. Russell Holmes, one of the bill’s co-sponsors, told Yahoo News that he has his own ethical concerns with it. While he agrees in practice with creating a pathway for organ donations, he admitted that he did not support the current bill in totality because he had no idea that its final language would have an incentive tied to it.

Holmes said that he hastily agreed to co-sponsor a bill that would help to allow incarcerated people to donate their organs only to their own families and that he didn’t know about the additional provisions.

“I’m signed onto something that’s not a hundred percent what I believe, but I am thankful that we at least are finally having a conversation about Black and brown folks not being in this pool,” he said, reiterating that he “would not want do anything to victimize those who do not have [much], and that’s who many people in prison are.”

Pointing to his record within the community as the state’s longest-serving Black and Latino Legislative Caucus member, Holmes said he understands the challenges of a legal system that has failed Black and Latino lives.

“We want to make an opportunity for folks to be able to have a process that seems fair to donate their organs or blood marrow to other family members without any incentive,” he said, adding that the “spirit of a bill is what I signed onto. The final version of a bill is what I vote on.”

Rep. Russell E. Holmes stands at a podium with hands raised, palms out, in front of flags.
Massachusetts state Rep. Russell Holmes in 2020. (Pat Greenhouse/The Boston Globe via Getty Images)

The U.S. Federal Bureau of Prisons currently allows incarcerated inmates to donate their kidneys to members of their family. But in many states, like Massachusetts, there is no official pathway to do so. It’s why Holmes said that though the language is off, he feels positive that people are beginning to talk about the issue.

“I’m thankful that at least we’re having the conversation that leads with Black people only being 29% likely to find a match, Hispanics 48% likely to find a match with bone marrow and white people 79%,” he said, citing the bone marrow registry Be the Match.

For Jesse White, policy director of Prisoner Legal Services of Massachusetts, any adequate program must prioritize the root cause of the problem.

“The solution must target the underlying structural problems leading to health disparities and must not be coercive or disproportionately impact another group, including incarcerated people,” White told Yahoo News.

For many, it sets a particularly poor precedent to begin dealing organs for an early release.

“We’re creating a double injustice for over-incarcerated populations by potentially using them as a source of easy bone marrow and/or organs,” Evans from UMass said. “This is a net negative for patients, prisoners, and the authors of the bill should be spending their time on medical and prison reform instead of this.”

“There is a profound concern for coercion and the ability to voluntarily consent given the magnetic pull of the quid pro quo of sentence reduction,” Margaret R. McLean, senior fellow at the Markkula Center for Applied Ethics at Santa Clara University in California, told Yahoo News. “I worry that this is a case of ‘selling’ organs and tissues, not for dollars but for priceless freedom.”


Cover thumbnail photos: Screengrab of video on Twitter/MikeSington