RFK Jr. Decertifies Kentucky Organ Procurement Organization

This article was published by National Review online on August 5, 2026.

Wesley Smith

By Wesley J. 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 That medical support is withdrawn with consent and if cardiac arrest occurs — sometimes it doesn’t and the patient is then to be returned to care — after three or so minutes the patient is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.

The case that caused the government to intervene is a real horror story as described by the New York Times:

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.

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.

Mr. Hoover eventually recovered, although he has lingering neurological injuries.

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.

US Senators urge Health and Human Services to monitor assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Senator James Lankford

There are now 13 US states as well as Washington DC that have legalized assisted suicide. A press release from US Senators James Lankford (R-OK) and Tim Kaine (D-VA) to Health and Human Services  (HHS) Secretary Robert F. Kennedy, Jr. urging HHS and the Centers for Medicare & Medicaid Services (CMS) urges them:

to establish reporting requirements in the hospice program to monitor physician-assisted suicide for discrimination against individuals with disabilities, older adults, and other vulnerable populations.

The letter warned Secretary Kennedy that assisted suicide:

“raises significant informed consent issues as well as concerns about disability and age discrimination” and noted that the vast majority of patients receiving physician-assisted suicide are enrolled in hospice.

Senator Tim Kaine

The Senators further stated:

“We urge HHS and CMS to establish reporting requirements to monitor physician-assisted suicide for discriminatory practices and oversee compliance with federal funding restrictions within hospice programs. All hospice patients—regardless of disability, age or financial means—deserve compassionate end-of-life care that is free of coercion and discrimination.”

The Senators were joined by US Representatives Greg Murphy, M.D. (R-NC-03) and Lou Correa (D-CA-46).

Link to the letter to Health and Human Services Secretary Robert F. Kennedy (Letter Link).

Rep Greg Murphy

The Euthanasia Prevention Coalition (EPC) shares the concerns of Senators Lankford and Kaine and Representatives Murphy and Correa. We are particularly concerned with the formulation and use of poison drug cocktails for assisted suicide that are not approved as "safe" by The Food and Drug Administration (FDA).

The letter from the Senators and Representatives states:

Physician-assisted suicide drugs are not approved for the purpose of ending human life. The Food and Drug Administration (FDA) has not approved drugs indicated for physician-assisted suicide. These drugs would not meet the criteria as "safe" for the purposes of the Federal Food, Drug, and Cosmetic Act. Instead, medical practitioners prescribe drugs approved for other indications to be used "off-label" for physician-assisted suicide. As the Atlantic reported in 2019, "[I]n states where the practice is legal, state governments provide guidance about which patients qualify but say nothing about which drugs to prescribe." With "no government-approved clinical drug trial, and no Institutional Review Board oversight," physician-assisted suicide drug prescribers are left with little oversight in assisting end-of-life patients"

Rep Lou Correa

EPC is also very concerned about abuses related to the Assisted Suicide Funding Restrictions Act that essentially restricts federal funding for assisted suicide and protects the conscience rights for medical practitioners who object to assisted suicide. The letter from the letter from the Senators and Representatives states:

We request that you establish reporting requirements within hospice programs regarding physician-assisted suicide. In doing so, please consider monitoring physician-assisted suicide practises for the following:

• Discrimination against individuals with disabilities, older adults, and other vulnerable populations; 

• Proper disposal of unused medication and prevention of drug diversion; 

• Insurance denials of life-sustaining medical care that offer to cover physician-assisted suicide drugs instead.

There are many concerns with assisted suicide laws and the practise of assisting suicides. Some of the key issues include the lack of clear oversight and the use of lethal poison drug cocktails. The drug cocktails are concerning for their use but also the abuse the occurred with their experimental development.

Reguest for Information Regarding Medical Aid in Dying

Letter from Senator James Lankford, Rep James L Correa and Rep Gregory F. Murphy (M.D.) to The Honorable Robert F. Kennedy, Jr. Secretary Centers for Medicare & Medicaid Services Department of Health and Human Services

June 1, 2026

RE: Request for Information Regarding Medical Aid in Dying (MAID) (CMS-1851-P) (RIN 0938-AV78)

Dear Secretary Kennedy:

We submit this comment as bipartisan, bicameral Members of Congress in response to the Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services’ (CMS) request for information regarding medical aid in dying (MAID), 91 Fed. Reg. 17338. Medically assisted suicide raises significant informed consent issues as well as concerns about disability and age discrimination. Since the vast majority of assisted suicide patients are enrolled in hospice—92% according to Oregon data and 90% according to Washington data‍1 this is problematic for HHS and CMS’ regulation of patient health and safety within the hospice program. We urge HHS and CMS to implement reporting requirements in the hospice program to monitor assisted suicide for discriminatory practices against vulnerable populations,‍2 as well as ensure compliance with the Assisted Suicide Funding Restriction Act.‍3

In 1997, the U.S. Supreme Court unanimously upheld Washington’s and New York’s bans on assisted suicide in Washington v. Glucksberg and Vacco v. Quill.‍4 The majority opinions found that there is no right to assisted suicide under the Due Process or Equal Protection Clauses.‍5 Justice Sandra Day O’Connor concurred, joined by Justice Ruth Bader Ginsburg and Justice Stephen Breyer, expressing concern about “the risk that a dying patient’s request for assistance in ending his or her life might not be truly voluntary.”‍6 Nearly thirty years of assisted suicide practice in the United States has not alleviated that concern.

Currently, thirteen states plus the District of Columbia permit assisted suicide.‍7 These laws permit certain medical practitioners to prescribe drugs at lethal dosages to a patient that is, among other criteria, eighteen years or older and “terminally ill” with a six month or less prognosis, with or without care, so that the patient may self-administer the drugs.‍8 Yet, as the National Council on Disability warns, under assisted suicide laws, “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.”‍9

There are grave informed consent issues within assisted suicide. Doctor shopping is rampant; Oregon data indicates the median patient-physician relationship is four weeks, with some relationships ranging as little as zero weeks.‍10 Mental health referrals are practically nonexistent, as only 0.5% of patients received them, even though many assisted suicide patients show signs of depression, which can impair the decision-making process.‍11 On top of this, “it is common for medical prognoses of a short life expectancy to be wrong,” and under the definition of terminal illness in assisted suicide laws, “[t]here is no requirement that the doctors consider the likely impact of medical treatment, counseling, and other supports on survival.”12

Assisted suicide drugs are experimental. The Food and Drug Administration (FDA) does not approve compounded drugs,‍13 which are commonly used in assisted suicide,‍14 and the FDA could never approve drugs indicated for assisted suicide because they are not “safe” for purposes of the Federal Food, Drug, and Cosmetic Act.‍15 As The Atlantic reported in 2019, “[i]n states where the practice is legal, state governments provide guidance about which patients qualify, but say nothing about which drugs to prescribe.”‍16 With “no government-approved clinical drug trial, and no Institutional Review Board oversight,” assisted suicide drug prescribers are left to experiment directly on end-of-life patients.‍17

Disability issues arise in assisted suicide. An individual with terminal illness meets the definition of a physical disability under the Americans with Disabilities Act and the Rehabilitation Act.‍18 In fact, individuals with disabilities and disability rights groups have raised this argument and alleged assisted suicide laws violate federal disability rights laws in litigation across the country.‍19 Patients seeking assisted suicide commonly request assisted suicide, not due to pain or concerns about future pain, but for disability-related reasons, citing concerns about “loss of autonomy,” being “less able to engage in activities,” and “loss of dignity.”‍20 Consequently, assisted suicide stigmatizes disabilities, and sends the message that the lives of persons with disabilities are less valued in society.

Age discrimination and elder abuse are also concerns within assisted suicide practices. Most assisted suicide patients are age 65 or older (88.3% under Oregon data and 86.2% under Washington data).‍21 Although assisted suicide laws require two witnesses to the lethal drug request, most states only require one witness to be disinterested, meaning, one of these witnesses may be a beneficiary to the patient’s will or life insurance policy.‍22 Assisted suicide laws do not require a prescriber or any witnesses to be present when the patient self-administers the drugs.‍23 Especially with patient age and education demographics—most patients are well educated—these circumstances are “consistent with elder abuse” and possible financial exploitation.‍24

Assisted suicide undermines America’s national posture of suicide prevention. America is facing an epidemic of suicide. In 2024, we lost more than 50,000 Americans to suicide and over 1.5 million Americans attempted suicide. Suicide is the eleventh leading cause of death in America and around 135 suicides occur every day on average. Additionally, over 14 million adults reported seriously considering suicide in 2024. Peer-reviewed data shows that where assisted suicide is legalized, rates of non-assisted suicide spike.25 Additionally, each year the U.S. government invests hundreds of millions of taxpayer dollars annually in suicide prevention services. States and localities spend millions each year as well. A 2024 NIH report shows that the economic cost of suicide/self-harm is estimated at $510 billion annually.26 New data shows that people living with serious and potentially life limiting health conditions are more than twice as likely to die by suicide compared with the general population.27 Assisted suicide undermines suicide prevention services, normalizes premature death for vulnerable populations, undermines their sense of autonomy and dignity, and pushes society away from robust care, support, and the protection of life.

Congress has restricted federal funding for assisted suicide and protected conscientious objections to the practice. The Assisted Suicide Funding Restriction Act broadly limits federal funds from “paying (directly or indirectly)” for the provision of “any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.”‍28 This prohibition extends to a “pay[ment] . . . for such an item or service” and a “pay[ment] (in whole or in part) for health benefit coverage” related to the coverage or expenses of “such an item or service.”‍29 The Affordable Care Act also provides anti-discrimination protections for an individual or institutional health care entity that does not participate in “assisted suicide, euthanasia, or mercy killing.”‍30

As you consider the assisted suicide issue further, we recommend you use the statutory language, “assisted suicide, euthanasia, or mercy killing,” which is more precise than “MAID.”‍31 “MAID” includes both assisted suicide and euthanasia,‍32 even though no jurisdiction in the United States permits euthanasia.

We also request that you establish reporting requirements within hospice programs regarding assisted suicide. In doing so, please consider monitoring assisted suicide practices for the following:

• Discrimination against individuals with disabilities, older persons, and other vulnerable groups; Eligibility of patients solely due to an eating disorder;‍33
• Proper disposal of unused medication and prevention of drug diversion;‍34
• Insurance denials of life-sustaining medical care that offer to cover assisted suicide drugs instead;‍35
• Drug complications;
• Experimentation of assisted suicide drug compounds;
• Compliance with federal restrictions on using funds, directly or indirectly, for health care items or services for assisted suicide.

As Senators and Members of Congress who are committed to the health and safety of hospice patients, especially those in vulnerable populations, we are grateful to see HHS and CMS consider how assisted suicide practices pose discrimination and informed consent issues. We urge HHS and CMS to establish reporting requirements to monitor assisted suicide for discriminatory practices and oversee compliance with federal funding restrictions within hospice programs. All hospice patients—regardless of physical disability, mental health, eating disorder, age, or financial means—deserve compassionate end-of-life care that is free of coercion and discrimination.

Sincerely,

James Lankford
United States Senator

J. Luis Correa
Member of Congress

Gregory F. Murphy, M.D.
Member of Congress

1 Oregon Death With Dignity Act: 2025 Data Summary (Oregon Report), Or. Health Auth. 1, 9 (Apr. 1, 2026), https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le8579_25.pdf; 2024 Death with Dignity (Washington Report), Wash. State Dep’t Health 1, 1 (July 2025), https://doh.wa.gov/sites/default/files/2026-02/422-109-DeathWithDignityAct2024.pdf.
2 See 42 U.S.C. § 1395x(dd)(2)(G) (directing hospice programs to “meet[] such other requirements as the Secretary may find necessary in the interest of the health and safety of the individuals who are provided care and services by such agency or organization”).
3 See 42 U.S.C. §§ 14401 to 14408; see also 41 C.F.R. § 411.15 (q) (2025).
4 Washington v. Glucksberg, 521 U.S. 702 (1997); Vacco v. Quill, 521 U.S. 793 (1997).
5 Glucksberg, 521 U.S. at 735; Vacco, 521 U.S. at 808.
6 Glucksberg, 521 U.S. at 738.
7 Euthanasia, Cornell L. Sch. Legal Info. Inst. (Oct. 2025), https://www.law.cornell.edu/wex/euthanasia; 410 Ill. Comp. Stat. 22/1 to /999 (2026) (eff. Sept. 12, 2026); N.Y. Pub. Health Law art. 28-F, §§ 2899-d to -s (McKinney 2026) (eff. Aug. 5, 2026).
8 E.g., Or. Rev. Stat. §§ 127.800, 127.805 (2023).
9 Nat’l Council on Disability, The Danger of Assisted Suicide Laws, Bioethics & Disability Series 14–15 (2019).
10 Oregon Report, supra note 1, at 18.
11 See id. at 15.
12 Nat’l Council on Disability, supra note 9, at 21–22.
13 Human Drug Compounding Laws, U.S. Food & Drug Admin. (Dec. 17, 2024), https://www.fda.gov/drugs/humandrug-compounding/human-drug-compounding-laws.
14 See Oregon Report, supra note 1, at 22.
15 See 21 U.S.C. § 355(b)(1)(A)(i).
16 Jennie Dear, The Doctors Who Invented a New Way to Help People Die, Atlantic (Jan. 22, 2019), https://www.theatlantic.com/health/archive/2019/01/medical-aid-in-dying-medications/580591/.
17 Id.
18 See 42 U.S.C. § 12102; 29 U.S.C. § 705(9).
19 E.g., United Spinal Ass’n v. California, No. 24-2751 (9th Cir. argued Mar. 26, 2025).
20 Nat’l Council on Disability, supra note 9, at 37.
21 Oregon Report, supra note 1, at 12; Washington Report, supra note 1, at 4.
22 Margaret K. Dore, “Death With Dignity”: A Recipe for Elder Abuse and Homicide (Albeit Not by Name), 11 Marq. Elder’s Advisor 387, 388 (2012).
23 Nat’l Council on Disability, supra note 9, at 42.
24 Dore, supra note 22, at 396; see also About Abuse of Older Persons, U.S. Ctrs. for Disease Control & Prevention (Nov. 7, 2024), https://www.cdc.gov/elder-abuse/about/index.html.
25 https://sma.org/southern-medical-journal/article/how-does-legalization-of-physician-assisted-suicide-affect-ratesof-suicide/
26 https://pubmed.ncbi.nlm.nih.gov/38479565/
27https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesamongpeoplediagnosedwithseverehealthconditionsengland/2017to2020
28 42 U.S.C. § 14402(a)(1).
29 Id. § 14402(a)(2) to (3).
30 42 U.S.C. § 18113(a).
31 42 U.S.C. § 14402; 42 U.S.C. § 18113.
32 See Medical Assistance in Dying: Overview, Gov’t Can. (Aug. 27, 2025), https://www.canada.ca/en/healthcanada/services/health-services-benefits/medical-assistance-dying.html.
33 See Chelsea Roth & Catherine Cook-Cottone, Assisted Death in Eating Disorders: A Systematic Review of Cases and Clinical Rationales, Frontiers Psychiatry, July 31, 2024, at 1.
34 See Oregon Report, supra note 1, at 4 (noting 400 people died by assisted suicide in 2025, but prescribers wrote 637 prescriptions).
35 Nat’l Council on Disability, supra note 9, at 20–21.

Canada requires doctors to not list euthanasia as the cause of death.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

On April 23, I republished an article by Wesley Smith concerning a US Senate committee hearing whereby Senator James Lankford (R., Okla.) asked HHS Secretary Robert F. Kennedy Jr. about assisted suicide. Kennedy said assisted suicide is abhorrent. (starting at minute 3:30).

Smith's article corrected Kennedy who mistakenly stated that euthanasia was the No. 1 cause of death in Canada. Smith wrote that:

It is the fifth, with some 16,000 people being killed by doctors — and rising — each year.

Marissa Birnie was published by The Canadian Press on April 28, 2026 stating that Robert F. Kennedy Jr's statement was false, but the article inadvertently points out how Canada's euthanasia (MAiD) law lacks effective oversight by requiring that euthanasia not be listed as a cause of death. Birnie reports:

MAID does not appear on the list because it is not listed as a cause of death.

Statistics Canada codes and classifies causes of death in line with a system created by the World Health Organization, which records deaths according to their underlying cause.

The World Health Organization death reporting system is based on the fact that very few countries have legalized euthanasia.

Birnie points out that cancer is the most common reason for someone to be killed by euthanasia in Canada.

When patients die through MAID, the cause of death is coded to match the health condition that led them to seek MAID, Statistics Canada notes. Cancer was the most frequently reported underlying medical condition among Canadians who received MAID, accounting for 63.6 per cent of cases among patients whose death was reasonably foreseeable.

Birnie writes that Health Canada does not consider euthanasia to be a cause of death.

“The number of MAID provisions should not be compared to cause of death statistics in Canada in order to determine the prevalence (the proportion of all decedents) nor to rank MAID as a cause of death,”

But euthanasia (MAiD) is the cause of death. A person may have asked to be poisoned to death based on a medical condition but they are not required to attempt effective treatments before being killed by euthanasia in Canada. 

Canada also approves (Track 2) euthanasia for people who are not terminally ill but rather have a "grievous and irremediable medical condition" which means they have a disability. 

For Track 2 euthanasia deaths, the cause of death is always MAiD or death by lethal poison.

Further to that there are studies showing how people who are killed by euthanasia may have a treatable condition but forego effective treatment and are killed by euthanasia.

In the Netherlands euthanasia is considered a "last resort", even though doctors will ignore that requirement. In Canada terminal condition is not dependent on whether or not the condition can be effectively treated because there is no requirement to even attempt effective treatments.

Another factor is that (MAiD) euthanasia is not listed on the death certificate. Research in the Netherlands indicates that approximately 20% of the euthanasia deaths are not reported. When a person is killed by euthanasia, the doctor will sometimes fail to send in the required report to the Netherlands oversight commission. Some doctors do not report their euthanasia deaths as they consider it to be a private act.

The same could be happening in Canada except that the Canadian government has not commissioned a neutral research study to determine how Canadians are dying.

Therefore, if a Canadian doctor does not submit the required report to the Provincial oversight body and since the death certificate does not indicate that MAiD was the cause of death, therefore it is nearly impossible to know how many euthanasia deaths go unreported in Canada.

The death certificate needs to be accurate to assure at least a reasonable level of oversight exists when a person is poisoned to death by euthanasia.

Previous articles on this topic: (Read the articles).

Under reporting of euthanasia: (Read the articles).

Robert F Kennedy Jr. Calls Assisted Suicide ‘Abhorrent’

This article was published by National Review online on April 23, 2026

Wesley Smith

By Wesley J Smith

Assisted suicide is not discussed much at the federal level. But at a recent Senate committee hearing, Senator James Lankford (R., Okla.) asked HHS Secretary Robert F. Kennedy Jr. about his thoughts on assisted suicide. Kennedy was unequivocal (starting at minute 3:30):

Lankford: I want to switch to an issue we have not had a lot of time to talk about, and that is assisted suicide. We now have three states, California, Colorado, and Delaware that disability groups are filing against some of the assisted suicide laws because it seems to target those with disabilities and the Americans with Disabilities Act passed in 1990, that act has worked to protect those with disabilities, not incentivize them to take their own life. And so, this is an ongoing conversation on this and I think my question for you today . . . what is HHS doing to protect those with disabilities that may be targeted by those assisted suicide laws?

Kennedy: To me, I think those laws are abhorrent. And we just see in Canada today, I think the number one cause of death is assisted suicide, and as you say, it targets people with disabilities and people who are struggling in their lives. And I don’t think we can be a moral society, we can’t be a moral society around the globe if that becomes institutionalized throughout our society. So, I am happy to work with you in whatever way we can.

Kennedy is mistaken about euthanasia being the No. 1 cause of death in Canada. It is the fifth, with some 16,000 people being killed by doctors — and rising — each year.

But he is absolutely correct about the rest. Indeed, we can’t “be a moral society around the globe” if assisted suicide/euthanasia “becomes institutionalized throughout our society.”

Why? Legalizing hastened death devalues intrinsic human dignity (by creating killable castes of people), undermines equality (some suicides will be prevented, others facilitated), while offering utilitarian rewards (organ harvesting, saving health care resources, etc.) to states that allow doctors to facilitate the suicides of — or lethally jab — people who are sick, disabled, elderly, and/or mentally ill.

Good for Lankford for raising the issue and Kennedy for denigrating legalized assisted suicide for what it is: “Abhorrent.”