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Want To Murder Someone? Pennsylvania’s About To Make It Easier

Dick Teresi Author, The Undead
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Pennsylvania legislators are poised to pass into law an organ-transplant-donation bill that will make it easier for murderers to avoid detection and prosecution.

Two bills, almost identical, Senate Bill 850 (SB 850) and House Bill 30 (HB 30), according to its many bipartisan sponsors, will greatly increase the number of organ donors. There are currently 121,000 people on the national waitlist for organ transplants, and laws to increase the organ supply are perennially popular in many states. Those opposing such laws are commonly accused of condemning to death people on the waitlist.

Law enforcement officials, however, are taking exception to one section of HB 30 (and likewise SB 850) that would complicate the work of coroners and medical examiners, and can make it difficult to convict or even bring murderers to trial.

HB 30 gives ownership of the bodies of organ donors directly to the two organ procurement organizations (OPOs) that are promoting the bill: CORE, the Center for Organ Recovery & Education, and GOL, Gift of Life. The bill allows CORE and GOL to bypass coroners and medical examiners to place first dibs on the bodies of organ donors. SB 850 is simultaneously making its way through the Pennsylvania senate.

Presently, coroners must examine violent deaths — such as homicides and suicides — suspicious deaths, sudden and unexpected deaths and deaths without a doctor in attendance. They also look for signs of infectious diseases that could threaten the community or which are hospital induced.

After these exams, the bodies may be turned over to an OPO so that it may harvest and sell the organs.

HB 30 would reverse the order — it assigns the body of a potential donor directly to the OPO, and coroners would be in the position of going hat in hand to the OPO to ask for access to the body.

A coroner who needs the body unsullied by organ removal can object in writing, but the OPO would not have to honor the request. The OPOs say coroners may attend and view the harvests, and they will supply photographs of the body, blood samples and biopsies.

According to Susan M. Shanaman, chief lobbyist for the Pennsylvania State Coroners Association, photos and samples are useless for forensic purposes. Organ harvesters have no forensic training, and are not required to be surgeons or even medical doctors.

A coroner’s autopsy of, say, a murder victim, would unlikely be able to hold up in court if conducted after an organ harvest. Harvesters can leave hemorrhages in the neck, for example, or laryngeal fractures mimicking strangulation. Forceps used in organ removal can inflict pinch marks and tears that mimic trauma. And once a body is harvested, the organs, tissues, bones, eyes and other parts are scattered hither and yon around the globe.

A defense attorney could destroy a prosecution case based on the autopsy of an organ-harvested body. Famed forensic pathologist Cyril Wecht, a former coroner in Pennsylvania, has opposed the plan to bypass coroners.

Dave Freed, district attorney for Cumberland County, states that any proper criminal investigation must take place before organs are harvested. Freed spoke on behalf of the Pennsylvania District Attorneys Association. Even before the introduction of HB 30, coroners have been under attack. Shanaman claims that OPOs call coroners at all hours of the night to harass them into giving up bodies more quickly for organ retrieval. She says OPO workers phone coroners at 3 a.m. and call them “killers” because they’re delaying the delivery of organs to people on the waitlist.

Even before HB 30 or SB 850 have been voted into law, the effects of excluding the coroner have been felt in Pennsylvania. Last year, in Clearfield, a 2-year-old girl died from trauma, suspected to be shaken baby syndrome. The father and the estranged mother were the prime suspects, but the parents donated their daughter’s body to an OPO, which convinced a judge to let it bypass the coroner and go directly to harvest over the district attorney’s objections. This essentially put a halt to the criminal investigation.

Scenarios like this in the future would obviously apply to situations of domestic abuse, in which a husband would donate a wife’s body (or vice versa) or a parent would donate a child, as in the Clearfield case. Parents and spouses would have such authority as next of kin. But HB 30 expands the definition of “next of kin” so that almost anyone has the authority to donate a person for organ extraction.

According to HB 30, next of kin includes “a person that exhibited special care and concern for the decedent.” Shanaman points out that this could be almost anyone, including “someone from Meals on Wheels, clergy, hairdressers, barbers, someone who mows your lawn. There is no requirement that the person knows the medical history or wishes of the decedent.”

OPO workers have been known to appropriate the cellphones of the dead or dying to call their contacts in attempts to find someone to donate the body. In one instance they found a dead woman’s friend in Maryland who gave approval. There is nothing in HB 30 that prevents a suspect in a homicide, who is also “next of kin” by the bill’s definition, from donating the victim’s organs.

Under the new proposed law, it is virtually impossible for a person in Pennsylvania to escape being a donor. Let’s say you and your lawyer have executed an advance health care directive (a.k.a. a living will) that dictates life support be withheld or withdrawn. The OPO can void your directive if life support is required to keep your organs healthy for harvest. In other words, you would be kept alive against your will for an extended period so the OPO could maintain the health of your organs for the benefit of resale.

It is also likely under HB 30 that once you are registered as an organ donor, either via your driver’s license or through the state organ registry, you are always an organ donor. Even if you revoke your donation status in writing, the OPO is not obligated to check the registry to find out. If the harvesting technician is from another country or state where the organ donation laws are more liberal—say China—he has the option of following his own country’s laws, not Pennsylvania’s.

HB 30’s primary sponsor is Democratic state representative Joseph Petrarca Jr. Petrarca’s seat was formerly held by his father, Joseph Petrarca Sr., who was the recipient of a kidney transplant, and died while awaiting a second kidney. The vast majority of people on the organ transplant waitlist needing a kidney will not be granted one. Petrarca Jr. is also on the board of directors of CORE, which will benefit financially from HB 30.

Sheryl Delozier, a Republican representative, and a cosponsor of the bill, defended Petrarca’s apparent conflict of interest. “If someone’s going to put a bill forward,” she said. “Then it’s good that they have a passion for it.” She did express concern about the bill’s implications for law enforcement. Petrarca could not be reached for comment.

HB 30 has significance beyond Pennsylvania, given that the state has been a pioneer not only in transplant technology but in its aggressive pursuit of donor bodies. Pennsylvania leads the nation in harvesting bodies proportionate to its population, having harvested 12,383 bodies since 1988. Texas, with more than twice the population of Pennsylvania, has harvested about the same number of bodies, 12,918, in the same time period. OPOs in other states will be watching closely the outcome of Pennsylvania’s new bills.

Collecting donor bodies is as much about money as it is about extending lives on the waitlist. It is against the law for people to sell their organs, but OPOs are allowed to, and a single body can yield as much as $2 million to $3 million once everyone down the line takes his cut. Transplant surgeons are at the top of the medical food chain, making from $420,000 to $545,000 per year. But procuring organs can pay as well. Howard Nathan, president and CEO of Gift of Life, was paid $544,302 by GOL in 2011, according to IRS Form 990. Nathan said he originally had planned to go to medical school but stuck with procuring instead. He called his job “almost spiritual.”

There is a great deal of waste. Estimates vary, but anywhere from 20 to 30 percent of extracted organs—because a matching recipient is not found or because of the vicissitudes of allocation—are incinerated* or thrown into landfills. Money is still made because Medicare pays for the extraction of organs whether or not they are ultimately transplanted into a human being. OPOs are non-profits—which doesn’t mean they’re poor, just that they don’t pay taxes–and both CORE and GOL have built $10- to $12-million-dollar harvesting facilities in Pittsburgh and Philadelphia, respectively, where they transport brain-dead donors. This is another objection of coroners, who will have to chase bodies from their home counties to distant cities in order to get a second-hand look at them.

The OPOs in Pennsylvania have also profited from the Gov. Robert P. Casey Memorial Organ and Tissue Donation Awareness Fund. Every time a Pennsylvanian registers a car or renews a driver’s license, he has an option to donate a dollar to the fund, some of which was supposed to help the families of organ donors pay funeral and medical expenses. Two reporters from the Pittsburgh Tribune-Review, Andrew Conte and Luis Fábregas, tracked down what happened to the $10 million collected by the fund between 2000 and 2013, and found that none of it was spent to defray the expenses of donor families. A smaller fund was set up for donor families, but much of it was reallocated to CORE and GOL. Representative Petrarca has introduced an update to the original bill.

At this writing, HB 30 remains under consideration in the House Judiciary Committee, but SB 850 cleared the Senate Appropriations Committee Monday, and it could face a vote of the full Senate as early as this week.

*Update: Biological waste is often incinerated.