A Prisoners Role in a Utilitarian World
[I do not give permission for others to use this essay in any way, shape, or form without informing me. If you would like to use parts, or refer back to parts, ask me and I will consider.]
In California six years ago, a prison inmate serving fourteen years received a heart transplant for a viral heart condition, amongst much debate (“Prisoner”). Prisoners are citizens who have committed what is deemed by society as a wrong, and thus experience the revoking of certain freedoms and privileges. Should a prisoner be denied health care as well? What about the more specific case regarding an organ transplant? What are the ethical implications of allowing or denying inmates medical care of any sort? I shall look at the situation with the guidelines of the consequentialist theory of utilitarianism, thinking about both the Act-utilitarianism and Rule-utilitarianism sides and using both to further the assertion that denying most prisoners organ transplants would be in the best interests of our society.
Utilitarianism can be defined as a view which insists that “an act is morally right if and only if that act causes the greatest happiness for the greatest number” (Sinnot-Armstrong). When considering whether a choice is morally feasible or not, one must look at the consequences of the decision. Using a general statement, if the decision hurts more people than it helps, it is often considered morally wrong. On the other hand, if the decision helps and makes happy more people than it may hurt, the decision is morally the correct one to make. Utilitarianism, at its roots, is designed to procure more happiness than sadness for the greatest amount of people. There are two factions of Utilitarianism, the more traditional being Act-utilitarianism and the other being Rule-utilitarianism, a newer view. Act-utilitarianism is similar to the definition of utilitarianism as a whole; that one must, through choice, bring about the best results for all involved (“Utilitarianism”). Rule-utilitarianism, on the other hand, is the act of adopting a set of rules that are optimal to happiness and judging an act to be right or wrong based on these rules (Rachels 111).
When the case study is regarded in terms of Act-utilitarianism, one must consider the benefits and consequences of the act of the transplant. If the prisoner receives the transplant, a non-prisoner must wait longer for one, perhaps experiencing death during the wait. If the non-imprisoned citizen receives the transplant, the inmate may never receive a transplant in favor of other non-imprisoned people, and thus may die of a heart condition. Which end furthers the greatest good?
I will begin by analyzing different prisoner situations, starting with the example of a transplant being given to someone on death row. Assuming that every person who is involved in the case has equal standing, interest-wise (that is, no one person’s interests count for any less than another), Act-utilitarianism, acting at its very barest, would say that the prisoner should not get the transplant. It would be in more people’s best interests to have the heart go to another, non-imprisoned person, someone who would have more of an opportunity to accomplish something useful for society, while if the heart was given to the death row inmate, he is hardly likely to accomplish anything useful at all. In fact, his death is guaranteed in a matter of time, which gives him limited time to accomplish what little is possible inside of a cell. Thus, there is potential for happiness in all the friends and family of the free citizen, not to mention the others he or she could touch by exercising this freedom, in comparison to the small amount of happiness a prisoner could bring, probably only to his cellmates, or the few members of his family left supporting him after his incarceration, and only for a limited time. To give the heart to the inmate would be a waste of a good and very limited resource.
If the prisoner is only sentenced for a few years and is guaranteed to leave prison at some point, such as the inmate described above who received a heart transplant, Act-utilitarianism still insists that the organ would be put to better use on a non-inmate. Again, an inmate has reduced potential to cause happiness to many. Even when he leaves prison, he may be ostracized by others because of his imprisonment, denied jobs that guarantee status advancement, and could possibly end up back in jail, where he will again be considered next to useless because of his limited freedom and privileges.
American taxpayers also have the advantage over the prisoner in question. The estimated total cost to the taxpayers for the California inmates’ heart transplant was about one million dollars. Not only does this prisoner fail to contribute to society once he has this transplant, but he is taking money out of the taxpayer’s pockets as he does so, something that is certain not to make these taxpayers happy. One person’s happiness versus thousands? The equation is easy to solve.
Let us now progress to Rule-utilitarianism. “30 years ago, the U.S. Supreme Court ruled that prisoners were entitled to receive adequate medical care, effectively creating prisoner’s rights to health care” (Kahn 365). If we follow the basis of Rule-utilitarianism, a society would be better off with this rule than without. In this sense, the prisoner has every right to gain access to transplants, defined as “adequate medical care” and should not be denied one. However, a weakness of this argument lies in the fact that not all Americans are guaranteed medical care. In fact, many who are not prisoners are denied access to the transplant wait list. This is in direct defiance with the Rule-utilitarianism idea that all people should be created equally, another rule that society runs better with than without. Which rule should take precedence over the other? That all Americans should receive adequate and equal medical care, or that only prisoners should be guaranteed health care? Hopefully most would agree that the former is more feasible. But, this in turn validates the reason that prisoners should perhaps be able to have organ transplants, because they are equal. Quite a circular argument is created.
We must consider though, the role of prisoners. They have forsaken their privileges as members of normal society because they have not adhered to society’s rules, which in many ways, are similar or equal to those considered morally right by Rule-utilitarianism. Are they not now exempt from the rules promoted by society and Rule-utilitarianism? It is in our best interests to keep prisoners (excluding those who are in jail for a very short period of time) from receiving transplants, for that reason.
Naturally, Utilitarianism is not the end-all of moral stances, and should not ultimately decide whether or not prisoners should be able to have organ transplants. But from a purely consequentialist view, the idea is abhorrent in a sense. As I have outlined, the benefits of not allowing inmates transplants outweigh the benefits of actually doing so, and there I must remain.
Works Cited
Kahn, Jeffrey. “The Ethics of Organ Transplantation for Prisoners.” Seminars in Dialysis. 16.5 2003: 365-68.
“Prisoner Gets $1M Heart Transplant.” CBS News 31 Jan. 2002. .
Rachels, James and Stuart. The Elements of Moral Philosophy. New York: McGraw Hill, 2007.
Sinnot-Armstrong, W. “Consequentialism.” Stanford Encyclopedia of Philosophy. 2006. 7 May 2008. .
“Utilitarian Theories.” Online Guide to Ethics and Moral Philosophy. 2002. 7 May 2008. .
