INMATES AS ORGAN FORMS

Boston - AT LEAST it isn't China. In that benighted country, prisoners are
subject to both the worst of the old totalitarian ways and the crudest of
capitalism. On the one hand, you can still get executed in China for your
political beliefs. On the other hand, you can then have your organs sold in
the marketplace to the highest bidders.

In China, prison authorities prep pre-executed bodies to save the parts and
doctors stand by to reap the remains. It's even reported that prisoners with
prime organs and ready customers get bumped to the front of the execution
line.

But in Missouri, they aren't talking about postmortem sales figures. They
are however, considering a proposal to make death row prisoners an offer
they can't refuse. Under a bill just filed in the state legislature, an
inmate sentenced to death would be offered the option Of giving up his
kidney or bone marrow. For the price of a body part, he could have capital
punishment commuted to life without parole.

The use of prisoners as spare body-part factories, or organ farms if you
prefer, is the latest attempt to deal with what economists call drily a
problem of supply and demand.

In the United States there are 57,690 people on organ waiting lists. In
1996, one person died every three hours for want of a transplant. This gap
between the number of donors and the number of patients has enticed all
sorts of organ entrepreneurship. In the mid-1980s, a Virginia businessman
first came up with the idea of importing poor Third World people and paying
them for a kidney. This led then-Senator AI Gore to push through a law that
banned the sale of human organs and tissue.

While this law hasn't entirely blocked the market, it has blackened it. A
couple of weeks ago, two Chinese were arrested in an FBI sting in New York
for trying to sell the corneas, kidneys, livers and lungs of executed
prisoners.

Nevertheless, new schemes are being proposed. These include setting up a
futures market" - paying people now who agree to have their organs used
after death - and giving money to those who agree to part with their
relatives' postmortem parts.

We have been quite properly queasy about the free-market approach to the
human body. There are some things that aren't and shouldn't be for sale -
among them an "extra" cornea or "spare" kidney. We should be even more
uneasy about getting lifesaving surgery mixed up with the death penalty.
When you can make a dollar from a liver or lung, it becomes a grisly
incentive for capital punishment.

Missouri has just 87 prisoners on death row and this bill offers commutation
through transplantation. But do we really want justice determined by the
medical marketplace? While we're talking about equity, under this bill, a
murderer with a nice clean kidney could live. A murderer who wasn't as
healthy would get the lethal injection.

It's been a long, slow, hard sell to convince people to donate their own
organs and those of the people they loved. We have old and complex attitudes
toward death and the human body.

Every scheme that offers dollars for "donations " every incentive plan that
is tinged with coercion, is likely to undermine the whole system.

This is one area in which the much-lauded free market doesn't work and
doesn't belong. Kidneys aren't commodities and livers aren't objects. We
need more donors - not deal-makers.