Let’s Harvest the Organs of Death-Row Inmates

"Someone died waiting for that killer's heart. The liver, split two ways, could have saved two babies."

An unfortunate side effect of hanging or poisoning a man is that his organs go sour before they can be transplanted. Death-row inmates have repeatedly asked to donate their organs, but their requests are always denied. The simple reason is that execution generally ruins organs before they can be harvested. By the time you cut someone down from the gallows or pronounce the injection lethal, the heart and lungs will have thumped and puffed for the last time. Soon after, the kidneys start rotting, and before long nothing is useful but the corneas. Even with beheading- still practiced in Saudi Arabia-the heart and lungs probably wouldn't make it, says Douglas Hanto, chief transplant surgeon at Beth Israel Deaconess Medical Center in Boston.

But by using what the bioethicist Arthur Caplan calls "the Mayan Protocol"-a term derived from the ancient Mayan practice of vivisecting their human sacrifices-the removal of organs would itself be the method of execution. If this sounds inhumane, compare it to current practices: botched hangings, painfully long gassings, and messy electrocutions. Removal of the heart, lungs, and kidneys (under anesthesia, of course) would kill every time, without an instant of pain.

So far, the organs of all criminals executed in the United States have stayed with their original owners. Consider the loss. Someone died waiting for that killer's heart. Two died waiting for his kidneys, and two more suffocated for lack of his lungs. The liver, split two ways, could have saved two babies. Take the hair, bone, skin, ligaments, and fluids for grafts and transfusions, and all that's left of the donor's body could be shuffled off into a very petite coffin indeed. The inmate could allow nearly a dozen people to live, in exchange for a body he wouldn't be around to enjoy anyway. The math says we should encourage death-row organ donation.

Someone died waiting for that killer's heart. Two died waiting for his kidneys,

But medical ethics, which bars doctors from murdering patients, says we cannot. Physicians have come out strongly against participating in capital punishment, even to administer anesthesia or find a vein for lethal injection. The result: inaccurate injections, and a sometime torturous demise for the condemned. And the fraternity of surgeons is quite attached to its cardinal directive in vital-organ-transplant ethics, the aptly named "dead-donor rule." They will not take the lungs of someone still using them.

Moreover, Arthur Caplan says, issues of consent should haunt any doctor considering a Mayan-style transplant. We do not take organs from people-even dead people-who have not invited us to do so. Death-row inmates are trapped in cages and desperate to win favor from judges and prison guards. How do we know their invitations are sincere?

But the point of the dead-donor rule, and of doubting the apparently sincere consent of the condemned, is to ensure that donation is untainted by benefit or harm to the donor. To be sure of that, we need to request consent only after the courts deny the final appeal. Death-row inmates after their last appeal occupy a space between death and life, dead but not dead, unable to profit from the donation and unable to lose by withholding it. Some might object that it's never too late for a shocking last-minute exoneration. But this is an argument against capital punishment itself, not against the compassionate use of a dead man's organs.

The real objection to the Mayan Protocol is aesthetic. Many want executions to remain grim affairs, and don't want a condemned man to cloak his squalid final hour in the raiment of altruism. "To get the organs, you really have to take them right away, and that would change the mood from an execution to a sympathetic harvest," Caplan says. "Frankly, the families of many victims probably don't want that."

Plus, the medicalization of execution would creep everyone out. We like the state to kill neither too clinically (as with a multiple organ transplant) nor too medievally (by chopping off the head). Better, for the sake of all but the condemned and the people dying for his organs, to find a Goldilocks-style middle ground in execution-neither too controlled nor too chaotic.

But being creeped out is the price of living in a society that kills its criminals. If organ harvesting would make executions uncomfortably like human sacrifice, perhaps that's because our death chambers are already gory enough to make anyone but a Mayan high priest pale.

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