Opinion: Why it is significant HHS decertified an organ procurement organization

In October 2021, Anthony Thomas “TJ” Hoover II suffered cardiac arrest after a drug overdose and was transported to Baptist Health Richmond, a hospital in Kentucky. He was subsequently declared “brain dead.” As he was being transported to the operating room for surgeons to harvest his organs for transplantation, organ procurement organization (OPO) employee Natasha Miller recalled to NPR:

He was moving around — kind of thrashing. Like, moving, thrashing around on the bed. And then when we went over there, you could see he had tears coming down. He was crying visibly.

The surgeons refused to operate, but the supervisor for the OPO, Kentucky Organ Donor Affiliates (KODA), ordered the case coordinator: “You will find another surgeon [to harvest Hoover’s organs] or you’ll lose your job because we’re going to complete this case.”

Hoover’s case led to an investigation of the OPO Network for Hope by the U.S. Department of Health and Human Services (HHS). (Network for Hope was formed in October 2024 following the merger of KODA with LifeCenter Organ Donor Network.) HHS documented the failure of Network for Hope to observe basic safeguards to protect patients. For example, 29.3% of potential organ donors demonstrated “concerning features, including… neurological signs incompatible with organ donation.” Phrased less euphemistically, the patients were demonstrably alive.

An OPO is an agency designated by the federal government to oversee organ retrieval and allocation in a given geographic region. The federal government can decertify an OPO and give its contract to a competitor. Based on the findings of its investigation, on August 5th, HHS began the decertification process of Network for Hope, which serves all of Kentucky and portions of Indiana, Ohio, and West Virginia.

It’s important to note that HHS does not claim that the concept of “brain death” is invalid. Rather, the federal agency assumes that “brain death” is a valid concept, but is decertifying Network for Hope because patients did not meet the criteria for “brain death.” In other words, even the staunchest “brain death” proponent would agree that these patients were alive.

Perhaps the most remarkable aspect of the recent announcement by HHS is that Network for Hope was given a full year to fix these safety problems, but failed to do so. Tom Engels, Administrator of HHS’ Health Resources and Services Administration (HRSA), said:

HRSA, through its oversight of the OPTN [Organ Procurement and Transplantation Network], worked closely with Network of Hope [sic] over the past year through intensive monitoring and corrective action to address serious patient safety concerns. Despite those efforts, the organization did not demonstrate the improvements necessary to meet federal standards.

Besides the ethical imperative to correct the safety concerns, Network for Hope also had a compelling financial motive: decertification would lead to loss of its contract and thus a substantial loss of money. Thus, every reason exists to believe that Network for Hope both wanted to and tried to address the safety concerns. This leads to the alarming conclusion that Network for Hope could not make the necessary changes, that safeguards had been so widely ignored for so long a period of time that the system could not be fixed.

It may be that Network for Hope is an anomaly and that all other OPOs closely adhere to federal guidelines. However, it is also possible that Network for Hope is representative of widespread disregard for safety amongst OPOs. We cannot know until investigations have been performed.

What is the significance of this for Catholics?

In Pope Benedict XVI’s2008 address to the international conference on organ transplantation, he said we should always err on the side of life:

In an area such as this [the determination of death], in fact, there cannot be the slightest suspicion of arbitra[riness] and where certainty has not been attained the principle of precaution must prevail. … The principal criteria of respect for the life of the donator [donor] must always prevail so that the extraction of organs be performed only in the case of his/her true death. [emphasis added]

Moreover, in his 2000 Address to the 18^th International Congress of the Transplantation Society, Pope Saint John Paul II unambiguously stated that moral certainty must exist that patients are truly dead before their vital organs are harvested:

Moral certainty is considered the necessary and sufficient basis for an ethically correct course of action. Only where such certainty exists, and where informed consent has already been given by the [organ] donor or the donor’s legitimate representatives, is it morally right to initiate the technical procedures required for the removal of organs for transplant. [emphasis added]

If we Catholics abide by the principle of precaution articulated by Pope Benedict XVI and the stipulation requiring moral certainty articulated by Pope Saint John Paul II, it is clear that we cannot support the practice of harvesting vital organs from “dead” donors. The HHS investigation revealed that many patients are wrongly determined to be “brain dead” and are unquestionably alive, by any standard.

Moreover, many Catholics argue that all “brain-dead” patients are alive. Until such time as safety is ensured and consensus achieved on the issue of “brain death,” we should cease harvesting organs from “dead” donors. Innocent lives depend on it.