In 2007, the tragic result of a pardon created a big problem for Mike Huckabee in his run for the Republican presidential nomination, fairly or not.  If Haley Barbour decides to make a run at the 2012 spot, he may have to explain his thinking on a sentence suspension and the ethics involved in its conditions.  The Mississippi governor issued a suspension (not a commutation or pardon) to two sisters with life sentences for convictions in 1994 of an armed robbery that netted $11 total from two men they clubbed with shotguns in an ambush, but one sister has to donate a kidney to the other as a requirement of the commutation for both:

For 16 years, sisters Jamie and Gladys Scott have shared a life behind bars for their part in an $11 armed robbery. To share freedom, they must also share a kidney.

Mississippi Gov. Haley Barbour suspended the sisters’ life sentences on Wednesday, but 36-year-old Gladys Scott’s release is contingent on her giving a kidney to Jamie, her 38-year-old sister, who requires daily dialysis.

Normally a live kidney donation is an act of generosity and kindness, not a Get Out of Jail Free ticket.  And Barbour didn’t mince words about why this particular condition was part of the deal:

The Scott sisters are eligible for parole in 2014, but Barbour said prison officials no longer think they are a threat to society and Jamie’s medical condition is costing the state a lot of money.

[Defense attorney Chokwe] Lumumba said he has no problem with the governor requiring Gladys to offer up her organ because “Gladys actually volunteered that as part of her petition.”

Lumumba may not have a problem with the condition, but this is at least one sticky ethical wicket of the suspension.  Right now, the state pays for Jamie Scott’s dialysis because of her status as an inmate in a state prison.  Once Scott gets sprung, however, her case gets treated like anyone else with end-stage renal disease (ESRD), through Medicare.  Congress mandated Medicare coverage for all cases of ESRD, including coverage for transplants and the continuing care afterward.

By releasing Jamie Scott, Barbour has essentially transferred those costs from the state of Mississippi — at least for the dialysis treatments — to the federal government.  Had the Scotts conducted a kidney transplant while in prison, the state would likely have had to absorb either its entire cost or at least a significant portion of it, as well as the cost of the lifelong immune-suppression treatments, which I can tell you from years of personal experience are very high.  Even the federal government has trouble dealing rationally with them.

So the first ethical question is whether Barbour traded the detention of a violent offender to slough off the costs of care for Jamie Scott.  The second is whether Barbour essentially bought the transplant from Gladys Scott by trading her freedom for it.  Gladys may have volunteered to donate the kidney, but that volunteering came as a result of negotiations for a pardon or commutation.  Bear in mind that the federal government refuses to allow people who aren’t incarcerated to bargain for compensation for kidney donations, which would match people under no state duress at all to ESRD patients in a forum that prevents exploitation.  And if Gladys’ offer came organically, so to speak, why didn’t the state initiate a transplant before the issue of a pardon or commutation arose?

This seems like a very strange arrangement, to say the least.  Gladys is giving a gift to her sister that is beyond measure, and that is a blessing for the sisters.  But if the state wants to bargain for kidney donations, then why can’t private citizens do the same?