In Washington, transplant specialists are noting a significant increase in individuals opting out of organ donor registrations, a trend attributed to shaken public confidence following disturbing reports of a Kentucky man who was mistakenly declared dead. This incident, which occurred in 2021, has recently gained attention and raised serious questions about organ retrieval protocols. Fortunately, the man in question, who narrowly escaped organ donation surgery, is alive today. However, the fallout from this case has led to declines in registrations that could ultimately jeopardize the lives of those in need of transplants.
“Trust in organ donation is foundational,” stated Dorrie Dils, head of the Association of Organ Procurement Organizations. She emphasized that once this trust is compromised, recovering it can take many years. Under current legal standards, only physicians responsible for patient care can officially declare death; any involvement from organ donation personnel or transplant surgeons is strictly prohibited in this determination. This necessity raises critical concerns regarding the criteria used by medical professionals to ascertain death and the protocols for addressing uncertainty.
Dr. Daniel Sulmasy, a bioethicist at Georgetown University, indicated that thorough testing by all doctors involved is crucial to ensuring accurate determinations. The Kentucky incident first emerged during a congressional hearing a month ago, with media reports later detailing that a man, who had been declared dead days earlier, regained consciousness en route to an organ retrieval surgery, raising alarms about the initial assessment. Federal overseers of the U.S. transplant system are currently conducting an investigation, while the Kentucky attorney general’s office is evaluating the situation to determine an appropriate course of action. The OPOs and various donation organizations are advocating for prompt public disclosures regarding the investigation’s findings, urging caution in drawing conclusions until more details are available, as deviation from established protocols is deemed “unacceptable.”
The aftermath of the Kentucky case has seen a dramatic rise in individuals renouncing their participation in organ donation. According to Donate Life America, the number of people choosing to opt-out surged to an average of 170 daily within the week following the media coverage—this number is ten times higher compared to the same week in 2023. This statistic does not account for removal requests sent through emails or other state-based donation registries.
Dils reported that her organization, Gift of Life Michigan, typically receives between five to ten inquiries weekly from individuals wishing to retract their donor status. However, following the Kentucky incident, her staff handled 57 such requests in just one week, many of which directly referenced the troubling event. Similarly, the repercussions of the allegations echoed across the Atlantic in France, where laws stipulate that all residents consent to organ and tissue donation postmortem unless they actively decline.
Following the news from Kentucky, the number of people registering their refusal to donate in France surged from about 100 a day to approximately 1,000. Dr. Régis Bronchard, a deputy director at the French Biomedicine Agency, cautioned that this surge signifies distress and misunderstanding among the public, which could lead to dire outcomes if not mitigated.
To clarify the process surrounding organ donation, doctors can officially declare two varieties of death: cardiac death, which occurs when the heart and breathing cease permanently, and brain death, determined when all brain activity ceases following severe injury or stroke. Typically, organ donation candidates are brain-dead, with ventilators maintaining bodily functions long enough for potential organ retrieval procedures to be arranged by donor agencies.
Only a small fraction—roughly 1%—of deaths provide the opportunity for organ donation, as many individuals are promptly transferred to funeral homes or morgues after being declared dead. Once brain death is confirmed, donor agencies take over, seeking recipients and scheduling the surgical recovery of organs, with hospital nursing staff continuing to provide care up until the organs are collected.
In cases where there is uncertainty about the declaration of death, members of the donor agency, coordinating surgeons, or hospital staff are obliged to voice concerns immediately. Dr. Ginny Bumgardner, a transplant surgeon at Ohio State University, who also serves as the president of the American Society of Transplant Surgeons, stressed the rarity of such confusion, asserting that protocols are so stringent that delays occur if any doubt arises during the process. Throughout her three-decade career, Bumgardner stated she has never encountered a situation where the declaration of death was proven false.
While unusual discrepancies are noted to be infrequent, Georgetown’s Sulmasy acknowledged that practices regarding tests to establish brain death vary widely among hospitals. This inconsistency has prompted discussions about the need for enhanced testing protocols to reassure the public about the thoroughness of death assessments. Stricter standards may revive confidence in organ donation and deter individuals from withdrawing their willingness to donate.
