An eleventh-hour request by a prisoner on death row in an American jail to donate his organs is raising troubling moral and medical questions among transplant experts and ethicists.
Less than a day before child killer Ronald Phillips was set to die by lethal injection, John Kasich, the Republican governor of the state of Ohio, put off the execution to examine the request.
Phillips, 40, wants to give relatives a kidney before he is put to death, and his heart afterwards.
The governor said he was open to the possibility of Phillips donating a kidney or other non-vital organs before he is executed. But Kasich appeared to rule out a post-execution donation.
"I realise this is a bit of uncharted territory for Ohio," Kasich said, "but if another life can be saved by his willingness to donate his organs and tissues, then we should allow for that to happen."
Some medical experts and others warn that execution chemicals could render organs unusable. They are also deeply disturbed by the prospect of death row inmates donating organs, even if they can ease shortages so severe that patients die while on the waiting list.
They question whether the condemned can freely give consent, or are desperately hoping to win clemency. They worry that such practices would make judges and juries more likely to hand out death sentences. And they are troubled by the notion of using inmates for spare parts. Medical ethicist Arthur Caplan of New York University said organ donation was incompatible with the goals of punishment.
"It's unethical because this guy who's being executed raped and killed a three-year-old. When you donate your organs, there's a kind of redemption," Caplan said. "Punishment and organ donation don't go well together. I don't think the kinds of people we're executing we want to make in any way heroic."
Yet it's not unheard of for a death row inmate to become an organ donor. Steven Shelton, a condemned inmate in the state of Delaware, was allowed to donate a kidney to his mother in 1995. In 1996, the Alabama Supreme Court halted David Larry Nelson's execution so he could donate a kidney to his sick brother, who proved too ill for surgery.
Richard Dieter, executive director of the Washington-based Death Penalty Information Centre, which opposes capital punishment, said the practice raises troubling concerns. "Once you put the person into the death row or execution category, then their life becomes less in the equation of things," he said. "That's a slippery slope of one life being used to save another."
Anne Paschke, a spokeswoman for the United Network for Organ Sharing, said her organisation's ethics committee in 2007 deemed the practice morally reprehensible.
Caplan said keeping vital organs viable during executions would require avoiding methods that would harm them.