‘I’m Not Dead Yet!’

Ethical safeguards in medicine must be a priority:

Many of you know that my title refers to the 1975 film Monty Python and the Holy Grail. A scene involves a cart being pushed along a town street to pick up corpses. One guy is grabbed and about to be tossed into the cart, but he calls out, “I’m not dead!” That was one of many funny bits in the film. For those not in the know, you can see the short scene here: https://www.youtube.com/watch?v=EfOW9QrLs0o

But what is NOT so funny is how today’s organ donation industry might not be all that different from what the movie depicted. While a blessing to so many, there have always been ethical issues arising here. Getting a life-saving kidney transplant or some such thing can give many extra years to the recipient.

And generally Christians have more or less accepted these new medical developments. Yes, some cults, such as the Jehovah’s Witnesses even refuse blood transfusions, but that is the exception. Some people have died as a result of this. See more on that here: https://billmuehlenberg.com/2015/04/09/hermeneutics-and-blood-transfusions/

But what happens to the notion of human personality and personhood if this goes full tilt? What happens for example if and when brain transplants become viable? Movies have already looked into this, such as the 2018 film Replicas starring Keanu Reeves. Indeed, older novels such as Mary Shelley’s 1818 book Frankenstein (and its 1931 film version) were already dealing with such matters.

Various issues still need to be carefully thought through. One of the most obvious problems is the desire to push so strongly for organ donations, that human life is treated quite cavalierly in the process. Communist China has certainly led the way here. As I wrote in a piece 30 years ago:

A number of witnesses have testified that the Chinese government is satisfying its need for hard cash by executing young prisoners and then “harvesting” their organs while the bodies are still warm. The organs are then sold at black-market prices to Westerners eager to obtain them. https://billmuehlenberg.com/1995/09/02/beijing-follies-why-australia-should-not-go/

But it is not just China that seems to be pushing this reckless demand for human organs, sometimes at any price. In the West people can be operated on for their organs, even though they are not yet dead. ‘Are you serious Bill?’ you might be asking. I sure am, and this is not some isolated incident. Consider this title and subtitle from a lengthy New York Times article of a few days ago:

A push for more organ transplants is putting donors at risk

 

People across the United States have endured rushed or premature attempts to remove their organs. Some were gasping, crying or showing other signs of life.

The piece begins:

Last spring at a small Alabama hospital, a team of transplant surgeons prepared to cut into Misty Hawkins. The clock was ticking. Her organs wouldn’t be usable for much longer. Days earlier, she had been a vibrant 42-year-old with a playful sense of humor and a love for the Thunder Beach Motorcycle Rally. But after Ms. Hawkins choked while eating and fell into a coma, her mother decided to take her off life support and donate her organs. She was removed from a ventilator and, after 103 minutes, declared dead.

 

A surgeon made an incision in her chest and sawed through her breastbone. That’s when the doctors discovered her heart was beating. She appeared to be breathing. They were slicing into Ms. Hawkins while she was alive.

 

Across the United States, an intricate system of hospitals, doctors and nonprofit donation coordinators carries out tens of thousands of lifesaving transplants each year. At every step, it relies on carefully calibrated protocols to protect both donors and recipients.

 

But in recent years, as the system has pushed to increase transplants, a growing number of patients have endured premature or bungled attempts to retrieve their organs. Though Ms. Hawkins’s case is an extreme example of what can go wrong, a New York Times examination revealed a pattern of rushed decision-making that has prioritized the need for more organs over the safety of potential donors.

 

In New Mexico, a woman was subjected to days of preparation for donation, even after her family said that she seemed to be regaining consciousness, which she eventually did. In Florida, a man cried and bit on his breathing tube but was still withdrawn from life support. In West Virginia, doctors were appalled when coordinators asked a paralyzed man coming off sedatives in an operating room for consent to remove his organs.

 

Stories like these have emerged as the transplant system has increasingly turned to a type of organ removal called donation after circulatory death. It accounted for a third of all donations last year: about 20,000 organs, triple the number from five years earlier. https://www.nytimes.com/2025/07/20/us/organ-transplants-donors-alive.html

Wow. That is shocking stuff. Most of us would have heard of a patient being operated on for something and the anaesthesia did not work properly or perhaps was not administered. That is bad enough, but imagine being alive when doctors and surgeons are seeking to remove your body parts!

Some commentary on this situation is worth presenting. Bioethicist Wesley J. Smith said this about the situation:

The “dead donor rule” is the cement that binds the public’s trust in organ transplant medicine. Under the DDR (other than in living donations, such as of one kidney) organs cannot be procured unless donors, in the words of the Munchkins, are not be merely dead but really most sincerely dead.

 

There are two means of declaring death. Let’s call the first “heart death,” that is an irreversible cessation of all cardio/pulmonary function. The other is popularly known as “brain death,” (death declared by neurological criteria) in which function in the whole brain and each of its constituent parts have irreversibly ceased. The key word in both means of declaring death is “irreversible.”

 

But something appears to have gone badly off the rails in the field of procuring organs after heart death….

He goes on to discuss the article in the NYT and closes with these words:

I have worried often that there is a temptation to treat organ donor patients — who are subjects as long as they are alive — as objects once they are seen as dying, toward the perceived greater good of saving the lives of people who need organs. That can’t be allowed to happen. It is not only wrong, but from a purely utilitarian perspective, if people lose faith in the donation system, the number of available organs will decline as fewer people sign up to donate. In such a circumstance, recipients will become the primary victims of popular distrust. https://www.nationalreview.com/corner/organ-procurement-organization-lapses-threaten-trust-in-transplant-medicine/

Lastly, one medical doctor said this about what is now happening in the US:

On July 21, 2025, the U.S. Department of Health and Human Services (HHS) under Robert F. Kennedy, Jr. announced a major push to begin reforming the U.S. organ procurement and transplantation system. This announcement was prompted by a Health Resources and Services Administration (HRSA) investigation that uncovered multiple examples of patients who were not dead when they were taken for organ procurement.

 

The HRSA investigation revealed that out of 351 cases studied, 103 (29.3 percent) were found to have problems. They discovered 73 patients (21 percent) who were authorized for organ procurement despite having neurological signs incompatible with organ donation. And disturbingly, at least 28 patients (8 percent) may not have been deceased when doctors began surgery to remove their organs.

 

The independent HRSA investigation began after the Organ Procurement and Transplantation Network (OPTN) claimed to find no major concerns in their review of the 2021 TJ Hoover case. TJ Hoover, a supposedly “brain dead” man, began thrashing and crying as he was being wheeled to the operating room to donate his organs. His family was told that this was just “reflexes.”

 

Whistleblowers claimed that even after two doctors refused to remove Hoover’s organs, Kentucky Organ Donor Affiliates ordered their staff to find another doctor to perform the surgery. Thankfully, surgery was called off, and Hoover went on to recover and even dance at his sister’s wedding.

She concludes this way:

Yesterday morning, I sent a formal complaint to the OPTN, HRSA, and the investigating U.S. House committee that was signed by over 300 doctors, nurses, lawyers, philosophers, PhDs, and citizens.

 

I am very encouraged that so many are finally taking these deeply problematic practices seriously. But going forward, this is going to be a difficult moral, medical, and legal knot to untangle. As our country seeks solutions, these are the key goals I have identified:

 

1. The public needs full transparency about how death is declared prior to organ and tissue procurement, for without transparency there is no true consent.
2. We need an opt-out exemption to a brain death diagnosis nationwide. There are eight states with medical freedom laws that allow healthcare providers to opt out of participating in a brain death case, but the only state where patients have this right is New Jersey. And New Jersey’s law only provides for a religious exemption: people should be able to opt out for any reason.
3. Hospitals must mandate that doctors obtain informed consent before embarking on a brain death diagnosis, including the dangerous apnea test that can make a brain injury worse and has risks of hypotension, pneumothorax, and cardiac arrest.

It is also encouraging that many doctors are now taking a closer look at organ procurement and are interested in making changes. Living donation, in which both the donor and the recipient remain alive after the procedure, is completely ethical and can provide every organ except the heart. And a fully implantable artificial heart is currently in clinical trials. I am hoping that greater transparency will actually lead to more life-saving transplants, not less. After all, “brain death” accounts for <1% of reported deaths nationwide, whereas the number of living donors is potentially vast.

 

Hopefully we can provide justice for the families who have been hurt by the current unethical system without jeopardizing ethical forms of organ transplantation. https://www.lifesitenews.com/analysis/trump-hhs-finds-patients-are-taken-for-organ-retrieval-while-still-alive-launches-major-reform/

What we have here is the age-old problem of science and technology rushing ahead of proper ethical consideration and reflection. This needs to be reversed, and soon.

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