Ohio's governor has postponed the execution of a child-killer so he can study his offer to donate organs — a proposal that experts say would be a logistical nightmare and an ethical minefield.
"The only options for executing someone to obtain vital organs is to either shoot them in the head or chop their head off and have a team of doctors ready to step in immediately," said Arthur Caplan, a professor of medical ethics at NYU Langone Medical Center.
Theoretically, he said, the method of execution could be the removal of the organs under anesthesia.
"The problem is no doctor is going to do it," he said. "It violates all medical ethics and now you're making the doctor the executioner."
Those are some of the practicalities that Ohio Gov. John Kasich will have to consider as he explores the possibility of allowing death-row inmate Ronald Phillips, 40, to give his organs to ailing relatives or members of the public.
Phillips, who was convicted of raping and beating to death his girlfriend's 3-year-old in 1993, was one day away from a lethal injection when Kasich stayed his execution so he could weigh his donation request.
"I realize this is a bit of uncharted territory for Ohio, but if another life can be saved by his willingness to donate his organs and tissues then we should allow for that to happen," the first-term Republican said in a statement.
Some ethicists say the life-for-a-life equation isn't that simple.
The United Network for Organ Sharing, the non-profit organization that coordinates transplants across the country, called the scenario "ethically troubling."
"Allowing condemned prisoners to donate organs could provide an inappropriate incentive to execute prisoners and could lead to significant human rights violations," Alexandra Glazier, head of UNOS' ethics committee, said in a statement.
She said allowing prisoners facing death to donate organs could also muddy the ideal of "coercion-free consent."
"Taking organs from a condemned prisoner is not generally seen as an ethically appropriate way for the U.S. to expand the availability of organs for transplantation."
But Sally Satel, a psychiatrist who is a scholar at the American Enterprise Institute, said a donation policy would be "humane" — both for people actively waiting for organs and for killers who are trying to make amends.
"Every organ helps," she said.
Satel scoffed at the notion that the possibility of a post-execution donation would encourage juries and judges to impose capital punishment.
"It's an absurd and morbid fantasy," she said. "This is just the kind of outlandish scare tactic people use when they have no rational arguments against the issue."
There are more than 77,000 people actively waiting for organs, and the demand far outstrips the supply, according to UNOS.
With the number of executions in the U.S. hovering between 40 and 50, organs from death row are not going to solve the chronic shortage, Caplan said.
To donate a organ, a person usually has to die from a head injury that destroys the brain but leaves the rest of the body functioning. Life support is used to keep blood flowing to the organs until they are removed.
He said electrocution or lethal injection would injure the organs. Plus, the organs would have to be removed within five minutes to remain viable, which is not enough time to complete the formalities legally required in an execution.
The prison population would likely yield low-quality organs because of diet, lack of exercise and the high-rate of drug-related diseases such as HIV and hepatitis, Caplan said.
Dr. Jay Pal, a heart and transplant surgeon at the University of Washington Medical Center, said that even though up to seven people could benefit from the organs of a executed prisoner, he would not be comfortable with the process.
"It's very different to remove organs from someone who died in a car accident than it is to remove something from someone who is still alive," he said.
"I understand that person may not be alive for much longer for whatever crimes, but me personally, I think it would be very difficult knowing that's the act that killed somebody."
Phillips isn't the first death-row inmate to make the request. Christian Longo, facing execution for the murder of his wife and three children, asked to do the same two years ago and was turned down by authorities in Oregon.
Defense lawyer Tim Sweeney said his client has been praying and reflecting a lot in recent weeks as his final appeals — including a challenge to Ohio's plan to use an untested drug cocktail for the lethal injection — have been rejected.
He said that when he told Phillips about the seven-month reprieve, his reaction was: "God is good."
"Our client was very grateful the governor is going to give him time to explore this," Sweeney said.
"He'll have 230 more days of life and that's a very special thing. Hopefully he'll have the opportunity to do some good with that time if he's allowed to donate his organs."