Trent Nelson / AP Convicted murderer Ronnie Lee Gardner, who was executed in 2010, was part of the inspiration for a new Utah law that allows prisoners to donate organs. State Rep. Steve Eliason, who spearheaded the law, said it prevents valuable organs from "going to waste."

Joanne Ford was a designated organ donor for decades, years before she was sentenced to time in Utah’s Draper Prison for possession and distribution of methamphetamines.

But it wasn’t until two weeks ago that the 48-year-old inmate was guaranteed the right to honor her wishes if she happened to die while incarcerated.

Utah’s governor, Gary R. Herbert, signed the first state law on March 28 that explicitly permits general prisoners to sign up for organ donation -- and cracks the door to the controversial option of allowing death-row inmates to donate as well.

“I think, why not?” says Ford, who is among 247 Utah prisoners who’ve signed up to donate their organs. “If you have healthy organs, why would you not be able to help someone else?”’

Whether to accept organs from prisoners has long been a thorny issue. Ethics experts say it pits questions of coercion of a vulnerable population against the desperate need for organs in a country where nearly 118,000 people are waiting for hearts, kidneys, livers and other life-saving transplants, according to the United Network for Organ Sharing.

In most states, accepting organs from inmates who die while in custody is permitted only rarely and under strictly controlled circumstances. No state allows donation of organs from executed prisoners.

“In a case where the prisoner is on death row and the question is of harvesting organs after execution, I remain steadfastly opposed,” says Dr. Paul R. Helft, director of the Charles Warren Fairbanks Center for Medical Ethics at Indiana University.

The practice would “use unfree prisoners as a means to an end,” Helft says.

Others argue that there are also practical barriers to prison organ donation, such as high rates of disease, difficulty of retrieving organs quickly and execution methods that render organs unusable.

But not everyone believes those barriers should deter donation. Utah state Rep. Steve Eliason, who pushed the law through the legislature, said he was inspired by the 2010 death of Ronnie Lee Gardner, a murderer who wanted to donate his organs but was prohibited from doing so.

“How disappointing is that, there’s somebody who maybe wants to atone for his sins in some way,” says the Republican from Sandy, Utah. “It’s a waste of perfectly good organs that could help others.”

Eliason first proposed a bill allowing prisoners to donate organs last year, but time ran out before it could be fully considered. The next time, it passed unanimously.

Meanwhile, the Utah Department of Corrections already had begun allowing inmates to fill out organ donation cards voluntarily as part of their prison paperwork, said spokesman Steve Gehrke.

“We have more firm information on hand to have that back-up to know what that person’s wishes might be,” he said.

Now that the law has passed, records of inmates who want to donate have been sent to Intermountain Donor Services, the agency that manages organ donations in Utah. They’ve been added to the state donor registry.

“Any time we can expand the donor pool or make people aware of organ donation, we’re supportive of that,” says Alex McDonald, a spokesman.

The chance that the prisoners will become organ donors is very small; only 1 percent to 2 percent of deaths involve donation, McDonald says.

But every organ donor can save the lives of up to eight people and tissue donors can help more than 50 people, transplant experts say.

That’s long been the argument of Christian Longo, an Oregon death row inmate who has mounted an aggressive campaign from his cell to donate his organs after he’s executed. Longo, 39, who murdered his wife and three young children in 2001, has launched a website and a Facebook page and made his plea in a New York Times op-ed piece.

Oregon officials have declined to consider his request and, last year, Gov. John Kitzhaber announced a moratorium that halts death penalty executions.

Still, Longo is not deterred. In an email from prison, he said he is working to raise the issue of prison organ donation in other states first.

“Utah is the first success,” he wrote to NBC News. “Eventually I will use the success as weight to hopefully prompt Oregon to make a similar change. But for now, we’re helping other inmates navigate their states’ roadblocks.”

The Utah law does not discriminate between general population prisoners and death-row inmates, Eliason noted. “Any prisoner is able to do this,” he says.

Prison officials have not yet distributed the organ donation forms to the eight prisoners on Utah’s death row or to all of the 6,900 inmates in the system, Gehrke says. On average, about 10 prisoners die in custody each year in that state.

Some may wonder whether people in need would accept organs from prisoners, but Lori Haglund of Salt Lake City says there’s no question. Her son, Brock Butler, had a progressive liver disease. He died in September, a week before his 21st birthday, after spending three years on a waiting list for a liver.

“We were acutely aware of what we were asking someone to be giving,” says Haglund, 51. “For anyone who would be willing, it gives them a chance to give something back.”

Joanne Ford agrees. Although she may have damaged her organs, particularly her liver, with drug use, she still hopes she may one day help others.

“There still may be one or two things that could still possibly be used,” she says.

Donating her organs after death would be one way to atone for her actions -- in addition to prison time.

“I feel like I owe society a big debt,” she says. “I caused a great damage out there. I feel good about this.”

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