Kenneth Pike

Medical ethics?

Convicted rapist Kenneth Pike, of Auburn, N.Y., is expected to undergo a life-saving heart transplant that could cost up to $800,000 — a price that will be paid courtesy of New York state taxpayers.

The expense has outraged many crime victim advocates and community members, who say they cannot understand how the justice system can provide big-tag services for convicted felons arguably at the expense of innocent patients.

And the question of whether prisoners should receive equal, if not better, health care than law-abiding citizens has been the heart of a decades-long debate among medical ethicists.

In 1976, the U.S. Supreme Court ruled that prisoners were entitled to the same medical and dental treatment as everyone else in their community. Prisons that withhold necessary care from inmates can be held liable for violating constitutional bans against cruel and unusual punishment.

“We are constitutionally obligated to provide health care services to any inmate,” said Peter Cutler, citing the 8th Amendment of the Constutition. “We’re a state agency doing our job.”

Perhaps the taxpayers could convince the state that a penectomy is also in order.




  1. Arapahoe says:

    From your link:

    “Convicted rapist Kenneth Pike of Auburn, N.Y., has reportedly turned down a lifesaving heart transplant that would have cost New York taxpayers up to $800,000.

    Pike’s sister, Sharon Cardinal of Auburn, said Pike changed his mind about the transplant after news reports sparked controversy about inmates receiving big-ticket health services arguably at the expense of others, according to The Associated Press.”

    Moral quandary solved.

  2. Arapahoe says:

    My mistake. That quote wasn’t from your link ,but from the story at abcnews.go.com/health.

  3. alex says:

    Another consequence of our “taxation-under-threat-of-violence” system. The only moral solution to this kind of thing is to let those who want to fund it fund it and those that don’t don’t.

  4. Tippis says:

    So…

    …what’s the problem?

  5. soundwash says:

    Nice manipulation of (non)news..

    however.. who cares if a convict was gonna get it? The real madness is friggen $800,000 for a surgery?

    WTF kinda bullchit is that?

    -s

  6. usa1 says:

    Regardless of who is receiving the heart transplant, we as a country, need to decide if it makes sense to spend $800,000 to extend one life when many, many more lives could be saved with preventative or minor treatments.

    Rationing? You bet. It needs to happen especially since we are bankrupt as a country.

  7. sargasso_c says:

    The Medical Establishment have a lot to answer for when the only rational life preserving surgical proceedure costs a whole weeks wages for the Chair of the NYSE. This is outrageous.

  8. chuck says:

    I have no objection to “prisoners being entitled to the same medical and dental treatment as everyone else in their community.”

    But, like everyone else in the community, they can pay for it too. Or use their health insurance. If they can’t afford it, they are entitled to die.

  9. Skeptic says:

    Re: #6, “the real madness is friggen $800,000 for a surgery?”

    …soundwash nailed it.

    Animby (are your ears burning?), would you happen to know why a surgery like that would coast so much?

  10. chuck says:

    #11 – why does the surgery cost $800K?

    The short answer is: because the state was going to pay for it. So the hospital jumped at the chance to maximize it’s billing. So $1,000 for aspirin.

    If an insurance company was paying, they’d probably have a negotiated rate for every aspect of the surgery: the cost of the surgeon, anesthesia, medication, recovery costs, etc.

  11. Animby - just phoning it in says:

    Down, boys. Whether has turned down the treatment or not is not the point. The question is, should prisoners be treated to this sort of advanced medical care?

    Personally, I think it should be available to them. If they are suitable candidates.

    And, on that point, we have committees that evaluate every transplant application and a million reasons and risk factors to deny one. I would think a convicted rapist in prison would not be a good candidate. And then, of course, they would have to wait until a suitable heart was available and all candidates ahead of him on the approved list were served. He is unlikely to have ever received a new heart.

    #11 Skeptic – Remember, it takes two specialized surgical teams – one to harvest the heart and another to implant it. Now, we don’t do a lot of transplants here in the field but I suspect that total price also includes all his follow-up and the anti-rejection drugs which, at $20 or $30K per month adds another quarter million a year! Also, he is eleigible for parole in a couple of years so that $800K may include the cost of his care until they expect he will be paroled. Then, of course, he’d end up on Medicaid and we would still end up paying the freight.

    BTW Martin: You question mark the term Medical Ethics. This story has very little to do with medical ethics. It is about legislated and court-ordered care.

  12. Hyph3n says:

    Chuck, considering the average cost of a heart transplant in 2008 for an average Joe was $787,700, $800K doesn’t seem out of line too much.

    http://www.transplantliving.org/beforethetransplant/finance/costs.aspx

    The irony is that the health care for prisoners is only considered “better” because so many people have really bad health care.

  13. Tippis says:

    #14: “The irony is that the health care for prisoners is only considered “better” because so many people have really bad health care.”

    That seems like a much bigger problem…

  14. sargasso_c says:

    A correction to my earlier post. The Chair of the NYSE does not earn $800,000 a week. He makes that a day.

  15. KD Martin says:

    #13, Animby, from the article:

    Caplan said there haven’t been too many cases of prisoners approved for organ donations.

    “In general, the ethics of medicine is not to sort out sinners and saints,” he said.

  16. Ruger LCR says:

    He turned it down, but the liberal suck asses who run this fucked up country are still willing to spend 3/4 of a million dollars on an old fuckbag rapist just to keep him going a bit longer. And I believe my taxes are still due every year, whether or not I agree to how the money is spent.

  17. MikeN says:

    #7 hey , i thought death panels were a myth?

  18. Sea Lawyer says:

    #1, the real moral problem is why is everybody engaged in the organ transplant industry allowed to profit from it except for the one who donates the organ?

  19. chuck says:

    #16 – ok, so the chair of NYSE can afford to get a heart transplant every day. So what?

    The NYSE is not a government agency – they can pay their Chair whatever their shareholders or owners approve of.

    Until they get a bail-out.

  20. Skeptic says:

    Re: #13, thanks Animby. It still seems like an exorbitant amount even considering all the costs. That’s like… 40 brand new Ford Fusions! 🙂

  21. Avery Bodywins says:

    #21 – I agree! How ’bout this. Everybody does it “at cost”, “good samaritan” rules apply all around (i.e. no lawyers), and the donor gets a cut of the insurance premium for every year the recepient lives beyond his pre-transplant calculated end of life.

    Sounds complicated, but isn’t everthing?

  22. msbpodcast says:

    In # 10 chuck said:I have no objection to “prisoners being entitled to the same medical and dental treatment as everyone else in their community.”.

    Well I don’t know about where you live but here in New Jersey, its none, zip, nada, Sweet Fanny Adams, TB (Too Bad,) NG (No Good).

    You teeth can wear down to rotten, purulent, pus-filled putrefying stumps, not even insurers give a fuck.

    Pay for your own fuckin’ dentures seems to be the general consensus, and don’t drink water in Joyzee, who don’t know who’se died in it/from it.

    Yes, nuttin’ says “Eat shit and die!* like looking for any compassion coming from your fellow citizens.

    *Its a song by Margaret Cho.

  23. msbpodcast says:

    In #21 Sea Lawyer said: allowed to profit from it except for the one who donates the organ?.

    ‘Cause they’d offer to write him a cheque, but they know he wouldn’t be around to cash it?

    That’s like suing for a botched autopsy performed on yourself.

  24. muddauber says:

    OK, I’ll go ahead and say it, “That’s what wrong with this country today!”
    Now the issue for me is not that we provide health care for the criminals
    of the world, but that we provide more and better health care for criminals
    than we do for law abiding people. The other issue is that the laws state
    we (government, schools, hospitials etc) must provide these services or
    be subject to excessive fines and sanctions.

    Stephen J. Markman aptly pointed out in “The Coming Constitutional Debate”
    that our country is moving from the interpertation of the constitution from what
    are “rights” and interpreting the law around the idea of what the government can not do to us, to a interpretationof the constitution of what the country/government MUST do for us,
    or provide for us.

    “No state shall make or enforce any law which shall abridge the privileges
    or immunities of citizens of the United States. . . .” (Amendment XIV, §1)

    Stephen J. Markman goes on to state, “For the twenty-first century constitutionalist, perhaps the greatest virtue in redefining the Privileges or Immunities Clause is the prospect of transforming the Constitution from an “archaic” eighteenth-century guarantor of “negative liberties” into a
    genuinely “contemporary” charter of “affirmative government,” guaranteeing individuals
    an array of “positive” constitutional rights. “

    To translate that into layman’s terms, it means that we are moving from protecting
    rights and liberties to requiring that the government provide for a level of Privileges or Immunities.

  25. GregAllen says:

    It makes my head hurt to hear conservatives demand that the government should decide who is morally fit to get medical treatment.

  26. bobbo, high culture art critic says:

    Animby==you don’t see medical ethics as relevant to this issue? I’ll meet you more than half way and say that because there is a law right on point, yes it is the law that applies. but why is the law written the way it is? and does not any law remain open to debate on whether or not it is just? and so medical ethics is never irrelevant to a discussion of medical practice. Why isn’t it a medical principle that no doctor shall treat a criminal when a free man shall go wanting? That may be legal, but its not ethical==unless you are Greg Allan who sees all god’s children as equal be they child rapists, serial murderers, or the head of the NYSE. Oh wait, those ARE all the same. Nevermind.

  27. Animby - just phoning it in says:

    #17 Martin / #29 Bobbo : Medical ethics are the decisions a medical pro makes in the course of treating a patient. As Mt Martin points out in his quote, we don’t separate saints from sinners, we just take care of the ill. (Ideally.)
    As for refusing to care for a prisoner while a free person goes wanting? Setting aside the logistics, that would be a violation of law AND medical ethics. If you don’t like that prisoners are eligible for such care, vote conservative and change the law.
    Don’t blame the transplant team. They follow a strict protocol: when a heart becomes available, they take the next person on the list who is a match. While there are many factors involved in whether they are a match, criminal history is not one of them.

    Again, I say: This is not a case of medical ethics at work but rather a situation of court-ordered health care.

    # 24 Avery Bodywins said, “the donor gets a cut of the insurance premium”
    Ha Ha! Good one, Avery. Each “donor” should also get a good investment counselor, too!

    As for the tools above who proclaim prisoners should not get “better” health care? That’s just drivel. I doubt you can find a prison in the US and certainly not in the rest of the world where inmates get “better” care. They always are provided with the minimum care the law allows. If the man needs a transplant, he will be treated and evaluated for a heart transplant. IF approved, he will go on the list and wait his turn. Same as you. Same as me. No better, no worse. You can’t afford it? They won’t remove you from the list. Funds will be found.

    Again, I say. You don’t like it? Fine. Vote for legislators who will modify the law. Don’t blame the medics.

  28. Mr, Ed - the Original (with comma) says:

    Why is he so happy in the mug shot?

  29. bobbo, are we Men of Science, or Medical Ethicists? says:

    Animby–you are conflating medical ethics with medical practitioners. When medical practitioners “go along with” the law, they are acting upon medical ethics. Why do current medical ethics DICTATE that medical practitioners should take care of prisoners when non-prisnoners healthcare needs go wanting? Do you think just maybe the law might change if the AMA said none of its members should engage in heart transplants for prisoners as long as little kiddies didn’t get a full panel of vaccinations? Everything medical practitioners do is about medical ethics–the law may or may not coincide, although I can’t think of a single instance of disagreement. Which is the dog and which is the tail Animby? Have you ever owned a dog? Ha, ha. I hear you can’t have a tail without the head unless surgery is involved and that necessitates medical ethics.


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