By Ashley Bateman, Heartland Institute
A series of investigative articles and government reform initiatives over the summer has resulted in a record-breaking number of organ donors exiting the system.
Several articles published over the summer called nationwide attention to allegations of major inconsistencies and problems within the organ procurement industry.
In July 2025, a New York Times news article described scandalous practices of procurement companies harvesting organs from patients who still showed signs of life, of pressuring family members to approve organ retrieval and various other unethical practices.
The news outlet also published an op-ed written by cardiologists advocating for an expanded definition of brain death to increase the donor pool quickly. The article went viral.
Government Investigations
On July 21, Health and Human Services Secretary Robert F. Kennedy Jr. announced problematic practices and negligent oversight by the Biden administration’s Organ Procurement and Transplantation Network board of directors.
An HHS review of 351 incomplete organ-donation cases found nearly 30 percent of the cases were “concerning,” with 73 patients having displayed neurological signs that should have made them ineligible to serve as donors.
Simultaneously, the U.S. House Committee on Energy and Commerce started examining ethical breaches in organ transplantation
On August 7, Newsweek reported a 700 percent increase in donors retracting their status, with Donate Life America reporting a daily average of 412 retractions.
First-Hand Reports
Some health care workers have stepped back from the donor pool.
Kimberly Overton, BSN, RN, BC-FMP has years of experience in both hospice and intensive care units. Overton chose not to be an organ donor after witnessing failures by procurement companies firsthand.
“There were times in the ICU when I saw aggressive organ preservation measures take priority over patient comfort or family wishes,” said Overton. “I remember thinking, ‘Are we treating a person or managing a product?’ There were a lot of conversations and interventions from donor services that I felt were inappropriate and not handled well for such a sensitive topic and time.”
Concerns About Definition
The controversial and shifting definition of brain death has compromised transparency and decreased accountability in organ procurement, says Heidi Klessig, M.D., author of The Brain Death Fallacy.
“The AAN (American Academy of Neurology) guideline has been shown to be unable to predict irreversibility,” Klessig told Health Care News. “True death is an irreversible state. Brain death has been shown to be reversible and is not true death.”
The federal government’s Organdonor.gov website is factually incorrect in defining brain death and circulatory death, says Klessig.
“The site states brain death ‘occurs when the brain is totally and irreversibly non-functional’ as ‘caused by not enough blood supply of oxygen which causes the brain cells to die,’” said Klessig.
The AAN’s latest guidelines state brain death can be declared even if the hypothalamus continues to present function.
Questions About Consent
“People are right to withhold their consent for organ donation until there is complete transparency about the medical and ethical questions surrounding ‘brain death’ and ‘donation after circulatory death’ organ procurement,” said Klessig. “Without complete transparency, people are unable to give fully informed consent when they register as organ donors.”
The redefining of brain death over the years has moved it farther and farther away from how most people conceptualize death, says Overton.
“The tests that determine brain death can be inconsistent, and in some cases criteria are manipulated to expedite procurement,” said Overton. “I’ve cared for patients declared brain-dead who still had heartbeats, reflexes, hormonal activity, even spontaneous movements.
“To families, that looks and feels like life, because it is,” said Overton. “As a nurse, I’ve been in rooms where families were told their loved one was ‘gone,’ yet the monitor showed stable vital signs.”
People should be cautious about signing donation cards, says Klessig.
“Until correct information is provided to allow fully informed consent, registering as an organ donor remains hazardous,” Klessig said.
Ignoring Donor Wishes
Refusing to register as an organ donor is not a definitive exit strategy, as bodily autonomy and true informed consent are absent from the organ procurement process today, says Overton.
“Regardless of your donor status, whether you have a heart on your driver’s license or not, … if you are a viable candidate for organ donation, your family will be approached by donor services,” said Overton.
In response, advocacy organizations such as Halovoice.org offer a downloadable “donor refusal card.” Although states maintain organ donor registries listing organ donors, no state has a listing of those who do not want their organs donated, the organization states.
“If someone still wants to be a donor, I strongly encourage them to remove donor status from their driver’s license and instead put their wishes in writing, specifying exactly what circumstances they consent to donation under,” said Overton.
Families can enlist a trusted medical advocate, someone with knowledge on navigating complicated health care systems, says Overton. Overton developed her own organization, Remnant Healthcare, to advocate for vulnerable patients and support their families, having witnessed too many failures within the health care system.
HHS Action
“Procurement organizations operate with alarming autonomy, often without true oversight, and hospitals go along because it’s lucrative,” said Overton.
HHS has taken action against one major procurement company, shutting down the Life Alliance Organ Recovery Agency in September. Donate Life America, an organ donation advocacy organization, applauded the move as “strengthening public trust and patient safety.”
Ashley Bateman (bateman.ae@googlemail.com) writes from Virginia.
