The recent announcement by the Department of Health and Human Services that it will move to decertify one of the nation’s organ procurement organizations is one important element of a process to restore trust in America’s system of organ donation. But HHS should take further actions to build upon the Trump administration’s prior reforms and ensure that vulnerable human beings are never commoditized for their organs.
The action against the OPO serving Kentucky and parts of three neighboring states comes after horrific incidents involving patients’ organs being removed for donation while their bodies still showed signs of life. A federal investigation found that, of 351 cases between 2021 and 2024 where organ donation was authorized, but not completed by the Kentucky OPO, nearly one-third (103 cases) “had concerning features, including 73 patients (20.8%) on whom either the initial or subsequent neurological findings should have prompted earlier consideration of terminating” organ recovery. The New York Times reported on a separate incident where Alabama surgeons opened up a patient’s chest to begin organ recovery, only to discover her heart was still beating.
The outlet suggested that pressure on the OPOs to increase the number of organs transplanted has prompted the recent ghoulish incidents. But prior research has indicated that reforming the organ transplant system, which the first and second Trump administrations have prioritized, could result in as many as 28,000 new transplants annually. That increase in transplants can and should come from efficiency gains — for instance, doctors transplanting organs that are less than “perfect,” or transplant staff not accidentally throwing organs in the trash.
Where OPOs are cutting corners with dangerous and deadly consequences, HHS should move to revoke their certification, as a new law reforming the organ transplant system allows. But the Trump administration should also go further and seek to prevent a similar trend before it starts: a macabre proposal recently published in the New England Journal of Medicine to allow “death via organ donation.”
In a related interview, one of the journal’s authors explained the process: A patient “would receive an anesthetic, just like you would for any other surgical procedure, and under anesthesia, the organs would be removed. So they’d be removed while they’re still functioning.” In other words, the patient’s organs would be harvested while they’re still alive — with doctors causing the death via the harvesting.
The authors claim that new laws expanding assisted suicide — which is now legal in 13 states and the District of Columbia — make this concept more feasible. But the National Council on Disability, on which I served, explained how assisted suicide poses a particular threat to vulnerable patients: “if assisted suicide is legal, some people’s lives, particularly those of people with disabilities, will be ended without their fully informed and free consent, through mistakes, abuse, insufficient knowledge, and the unjust lack of better options.”
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We’ve already seen how some OPOs have engaged in unethical and unprofessional conduct to obtain organs from patients. Introducing assisted suicide as another option for OPOs to procure organs would raise even more questions — and likely harm more patients, particularly those with disabilities. That’s why the Trump administration and Congress should act to prevent any OPO from transplanting organs obtained via assisted suicide.
As the mother of a daughter with cystic fibrosis, I support organ donation and want to ensure Americans feel comfortable that their wishes will be respected. Decertifying OPOs who have engaged in the abuses that marked the Kentucky organization is a good first step in re-establishing patient trust. Preventing any potential link between assisted suicide and organ transplantation would continue this important process.
Mary Marslender is a former member of the National Council on Disability and the founder of Leverage PR.