A two-time convicted felon received a heart transplant last month at Stanford Medical Center. With more than 4,100 on the waiting list for a new heart—500 in California alone—taxpayers footed the bill for the inmate’s surgery, which could end up costing them up to $1 million, reported Reuters.

The transplant recipient was convicted of burglary and robbery.

Paying for inmates’ healthcare is not a new idea. Since 1976, the Supreme Court has held that “deliberate indifference” to inmates’ health problems amounted to cruel and unusual punishment, a violation of the Eighth Amendment, Russ Heimerich, spokesman for the State Department of Corrections, told the Sacramento Bee.

“The courts have told us that inmates have a constitutional right to healthcare,” Heimerich said. “The judge did not sentence this guy to death. And who knows, he may get out and become a productive citizen.”

The inmate had a viral infection which weakened his heart and he suffered congestive heart failure in December, Heimerich told the New York Times. The man’s severe condition resulted in his transfer to the Stanford Medical Center.

Stanford doctors agreed the inmate would die without the transplant, the Times reported.

“Doctors in medical practice don’t have a right to make social decisions,” Lawrence Schneiderman, medical professor at the University of California San Diego, told Associated Press. Schneiderman said the decision should be based on who the surgery will help the most, not who deserves it the most.

Anne Paschke, a spokeswoman for the United Network for Organ Sharing, the nonprofit group that manages transplant waiting lists, told Reuters that the doctors made the right decision.

The process does not take into account the person’s “prison status, just the way it does not look to see if they are famous celebrities,” Paschke told Reuters.

AP noted that UNOS does, in fact, make exceptions. In 1996 the organization decided that people suffering from long-term liver failure due to alcohol and drug abuse should only receive liver transplants after others on the list have been helped.

The transplant has not only raised concerns about the growing cost of healthcare for a large population of aging inmates, but also brings up the question of whether inmates are “worthy” of such expensive treatment.

David L. Perry, director of ethics programs at the Markkula Center for Applied Ethics and lecturer in religion studies at Santa Clara University, commented on the issue in an op-ed in the San Jose Mercury News.

“Most people would no doubt find it troubling that a criminal would get a major organ transplant while hundreds of law-abiding citizens who desperately need that organ are made to wait,” he wrote. “Imagine watching a loved one die for lack of a heart, then reading in the paper the story about our fortunate felon.”

Perry wrote that “those who deliberately threaten the lives of innocent persons thereby forfeit whatever moral claim they otherwise might have had to an organ transplant.”

Admitting that society should not make a habit of allocating organs based on a person’s “social worth,” Perry called for saving organ transplants for “nonviolent citizens who need them through no fault of their own.”

Jodi Mathews is BCE’s communications director.

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