Organ Donation

Organ transplantation has revolutionized modern medicine in good, but also some not-so-good ways. We think of organ donation as making the best of a tragic situation, but there’s a dark side that is rarely discussed. However, since the HHS report published last month pushed these concerns to the national stage, I’m taking the opportunity to highlight these concerns. Since organ transplantation became increasingly available in the 1960s, there have been ongoing ethical debates about the definition of death. Mostly this is to increase the availability of organs for donation. In principle, I’m not against organ or tissue donation. However, the ways to increase organ viability have life-threatening implications for the donor. Dead organs don’t work very well.

The HHS report states: The Health Resources and Services Administration (HRSA) examined 351 cases where organ donation was authorized, but ultimately not completed. It found:

• 103 cases (29.3%) showed concerning features, including 73 patients with neurological signs incompatible with organ donation.

• At least 28 patients may not have been deceased at the time organ procurement was initiated—raising serious ethical and legal questions.

• Evidence pointed to poor neurologic assessments, lack of coordination with medical teams, questionable consent practices, and misclassification of causes of death, particularly in overdose cases.

While the pursuit of life and the use of modern technology to prolong it is noble, it should never be at the expense of someone else’s, no matter how dire the situation. Further complicating the noble ambitions of transplant organizations is the fact that our organs, tissues, and bodies as a whole are worth a shocking amount of money. There is a lot of money to be made in the transplant industry – and I’m not talking about the illicit organ trade. Naturally, this leads to corruption (outright or rationalized) within any system. I think that the push for physician assisted suicide, aka “medical assistance in dying” (MAiD) is behind the drive for organ procurement. While the HHS report does not directly implicate nefarious motives, and I’m not saying that all transplants are bad or that the industry as a whole is nefarious. We can often become blind in the pursuit of something deemed as noble.

The more nefarious trade in organs and tissues involves the sale of organs and tissues, organ trafficking, and human trafficking for organ removal. Americans and other people from around the world are participating in “transplant tourism” in which the recipient traves to another country to receive a purchased organ from an unknown donor brokered by a trafficker. The recipient may not know what exactly is going on, but if you do not know the donor then you are likely a participant in this crime. Currently I’m developing a webinar to educate health care professionals and the public about organ trafficking.

From the website Respect for Human Life: “In 2023, the American Academy of Neurology issued a new brain death diagnosis guideline which does not comply with the law under the Uniform Determination of Death Act (UDDA). Thus, patients with severe brain injury are being diagnosed as ‘dead’ after only partial loss of brain function instead of the ‘irreversible cessation of all functions of the entire brain, including the brain stem’ as stipulated under the UDDA. People have a right to be declared dead in a manner that is both ethically sound and complies with the law.”

We don’t have to get as far as human trafficking to see that there are dire ethical issues surrounding organ transplantation. I urge you to do your own reading about this and decide for yourself and your family about whether to participate in organ donation or not.