This article was published by National Review online on August 5, 2026.
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| Wesley Smith |
Say what you will about Health and Human Services Secretary Robert F. Kennedy Jr., but he definitely cares about ensuring that organ transplant medicine remains ethical, and unlike many government functionaries, he and his department are actually doing something about it. Thus, on the back of Medicare decertifying a Florida organ procurement organization for cause in 2025, the government is now decertifying the Network for Hope that operates in Kentucky and a few other states.
The government warned the network last year that its procurement procedures were ethically deficient. But the organ procurement organization never cleaned up its act despite knowing it was being scrutinized, including, apparently, for seeking to procure organs from people who had not died.
The unethical cases involve a procedure sometimes known as heart death (as opposed to brain death). In a heart-death donation, the donor is usually receiving intensive care. That medical support is withdrawn with consent and if cardiac arrest occurs — sometimes it doesn’t and the patient is then to be returned to care — after three or so minutes the patient is declared-dead because cardiopulmonary function has irreversibly stopped. After that, the procurement commences.
In Kentucky, scrutiny began when a congressional committee heard testimony about the case of Anthony Thomas Hoover II, who had an overdose in 2021. After family members were told that he would not recover, they authorized donation.Mr. Hoover eventually recovered, although he has lingering neurological injuries.
As coordinators arranged for the surgery, Mr. Hoover began to stir, at one point “thrashing on the bed,” according to records reviewed by The Times. Still, Network for Hope, then called Kentucky Organ Donor Affiliates, tried to move forward. Finally, on the way to the operation, Mr. Hoover cried, pulled his knees to his head and shook his head, and a hospital doctor refused to withdraw life support.
Good grief.
Despite that case, Network for Hope avoided punishment. But then:
A federal investigation last year determined that the group had similarly ignored signs of growing alertness in more than 70 other patients. Although the organ removals were eventually cancelled, the investigation said multiple patients exhibited pain or distress as they were being readied for surgery. Overall, more than 100 cases had “concerning features,” the investigators said, noting that the majority of transplants arranged by the Kentucky group were from circulatory-death patients.Good for Kennedy and the government for moving on this. This is important. The people’s trust in organ transplant medicine is already shallow as unwise efforts to loosen ethical standards advocated by prominent bioethicists — such as allowing living people to be harvested — threaten to further erode public confidence. If we want to maximize the number of organs donated, people have to believe that their lives are deemed more important than their organs.
Next, the government should prohibit the use of a relatively new organ procurement procedure called “normothermic regional perfusion,” which allows cardiac arrest, cuts off circulation to the brain to induce brain death, and then restarts the heart before procurement. It seems to me — and I am far from alone in thinking this — that if someone is resuscitated successfully, he or she is not dead. Moreover, making patients brain-dead on purpose seems little different to me than actively killing them.
