The US organ donation system has recently come under fire after reports from Kentucky and elsewhere that patients who still showed signs of recovery were being rushed towards ending their lives for organ donation. See https://www.nytimes.com/2025/06/06/us/kentucky-organ-donations.html

The investigation focused on “donation after circulatory death”, referring to patients who are not brain dead but who are on life support/in a coma and are not expected to recover. Such patients are prepared for organ donation, taken to operating rooms, and taken off life support. Once they die, the organs can be harvested.

This practice exists because to be viable, organs typically must be harvested within a short time of death. There is thus incentive to prepare early, when patients are still living.

The New York Times details an investigation in Kentucky, where it was found that organ donation employees repeatedly pressured families to authorize donation, improperly took over cases from doctors and tried to push hospital staff to remove life support to allow for surgery even if there were indications of growing awareness in patients. They also failed to recognize the hospital sedatives or the patient's own drug use could mask the patient's neurological condition, meaning the patient was in better shape than they seemed.

One patient was moving and around and even looking around while he was in the operating room awaiting organ harvest. This patient ultimately was moved to the intensive care unit, where he lived another few days.

Another patient suffered a drug overdose, was unresponsive for two days, and his family agreed to organ donation. However, the patient slowly improved even as the donation process moved forward. He was thrashing in bed but then given sedatives. He was taken to the operating room to harvest his organs, but the medical staff was uncomfortable and kept stating this was a case of euthanasia. The procurement organization assured them it was not.

Finally, when the patient started pulling his knees to his chest and shook his head, a hospital physician refused to proceed to withdraw life support. The patient survived. But employees of the procurement organization said that their higher ups pressured the doctor to continue with the process. One employee was quoted as saying “If it had not been for that physician, we absolutely 1,000 percent would have moved forward.”

Investigators found 103 cases with “concerning features” and noted that the number of organ donations based on circulatory death had increased dramatically over the last few years.

Congress is now conducting hearings with the expectation of some reforms. Organ donation is of course laudable, but patients and their families must be fully informed and respected so that their fundamental rights and those of their loved ones are not violated.