Getting to the heart of any controversy is difficult, but when the heart, quite literally, becomes the heart of a controversy, it becomes twice as difficult. The controversy started when a prison inmate in California, USA, received a heart transplant in January 2002. The costs are being borne by California taxpayers and the transplant is expected to cost 1 million with follow up care. The United States supreme court ruled in 1976 that prisoners have a constitutional right to equal medical care. But, with more than 4,000 Americans on the waiting list for a heart transplant there just aren’t enough hearts to go around and some California taxpayers have questioned is an appropriate use of their tax money. The medical community frames the debate differently. To it, greatest medical need, not social worth, is paramount in deciding who gets a heart. “Everyone is treated the same once they get on that list,” said Dr. Bruce Reitz, the cardiothoracic surgeon who was part of the team that performed the transplant operation on the California inmate. “No one is treated differently, and that patient was not treated differently.” Arthur Caplan, a University of Pennsylvania medical ethicist and author of the book, “Ethics and Organ Transplants.” Says it’s up to state lawmakers to change the law if citizens don’t want prisoners to get organs. And so the controversy goes on