I talk a lot about estate planning with my clients, and organ donation often comes up in discussions about medical directives, so I wanted to share this New York Times investigation that revealed disturbing practices in the US organ transplant system that made me remove, for now, my donor status. Here’s what they found.
Danella’s Story
From the article: “In 2022, when she was 38 and homeless, Ms. Gallegos was hospitalized and went into a coma. Doctors at Presbyterian Hospital in Albuquerque told her family she would never recover.
Her relatives agreed to donation, but as preparations began, they saw tears in her eyes. Their concerns were dismissed, according to interviews with the family and eight hospital workers. Donation coordinators said the tears were a reflex.
On the day of the planned donation, Ms. Gallegos was taken to a pre-surgery room, where her two sisters held her hands. A doctor arrived to withdraw life support. Then a sister announced she had seen Ms. Gallegos move. The doctor asked her to blink her eyes, and she complied. The room erupted in gasps.
Still, hospital workers said, the procurement organization wanted to move forward. A coordinator said it was just reflexes and suggested morphine to reduce movements. The hospital refused. Instead, workers brought her back to her room, and she made a full recovery.”
Why Are They So Aggressive?
So why are organ procurement organizations being so aggressive? It seemingly comes down to money and survival. In 2020, the Department of Health and Human Services started grading these organizations based on how many transplants they arrange. Organizations that perform below average will lose their federal contracts, meaning they go out of business.
Listen to what Neva Williams, a veteran intensive care nurse, said about her experience with organ procurement organizations: “All they care about is getting organs. They’re so aggressive. It’s sickening.”
The Time Crunch Problem
What makes it even worse, there’s massive time pressure involved. Most donated organs come from brain-dead patients, which is relatively safe. But to boost their numbers, organizations are increasingly using “donation after circulatory death,” where patients are still alive with some brain activity.
With these patients, organs only stay viable for one to two hours after the heart stops. So there’s this frantic race against the clock to declare death quickly and get those organs out before they’re unusable. That time pressure, combined with the federal quota system, creates the perfect storm for cutting corners and premature death declarations.
The Medical Experts Don’t Even Know How Bad It Is
To add to my uneasiness about this process, there’s not even clarity on how prominent these events are. Dr. Wade Smith, a neurologist at UCSF who frequently evaluates potential donors, said: “I think these types of problems are happening much more than we know.”
And Dr. Robert Cannon, who’s actually a transplant surgeon himself, admitted: “I don’t know the scope of the problem. I don’t know that anybody does. That’s the scary thing.”
My Decision
After reading this investigation, I removed myself from the organ donor registry. I’m not against organ donation in principle, I believe it can save lives. But I can’t trust a system that prioritizes hitting quotas over protecting vulnerable patients who cannot advocate for themselves.
Until there’s accountability, reform and proper oversight, I’m not willing to take that risk.
The full New York Times investigation contains many more disturbing cases. I encourage you to read it and make your own informed decision about organ donation.