Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true patient care case. You vote on your decision in the case and, next week, we'll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.
The following case is adapted from Appel's 2019 book, .
Janet is an inmate on death row. She was accused of killing her stepmother with an axe -- a charge she adamantly denies -- and was convicted 3 months ago. Her case is now on appeal. Typically in the state where she was tried, 10 to 15 years elapse between conviction and execution, and 50% of defendants initially sentenced to death end up having their sentences either overturned or commuted.
While in prison, Janet develops partial heart failure due to a viral infection. She will require a heart transplant to survive. On a positive note, because she is a prisoner, she would likely receive excellent and consistent medical care to ensure the survival of a transplanted heart. At the same time, since hearts are scarce, if Janet were to receive a heart, someone else on the waiting list would likely die while waiting.
See the results and what an ethics expert has to say.
Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.
And check out some of our past Ethics Consult cases: