When I first became a licensed driver, checking the organ donor box seemed like a no-brainer.
I marked that option on my license, content with the idea that, even in death, I might be able to provide life. Recently, however, a troubling story surfaced that left me questioning the ethics of organ donation and the medical profession’s relationship with the dead — or, more disturbingly, the nearly dead.
Per an October National Public Radio story, Anthony Thomas “TJ” Hoover II, a 36-year-old man from Richmond, Kentucky, was declared brain-dead in 2021 following a drug overdose. Medical staff prepared him for organ donation surgery.
Natasha Miller, an organ preservationist assigned to Hoover’s case, told NPR she was preparing to do her job when nurses wheeled Hoover into the operating room and she realized “something wasn’t right.”
Hoover was moving, even visibly crying on the operating table, and yet the case coordinator allegedly pressured the team to proceed, even suggesting they “find another doctor” if necessary.
The situation became so alarming that the on-call surgeon refused to continue, and some staff, disturbed by what they witnessed, left their positions entirely. One preservationist, Nyckoletta Martin, later remarked, “It’s very scary to me now that these things are allowed to happen and there’s not more in place to protect donors.”
The most chilling part is that this wasn’t the first time Hoover showed signs of life. According to NPR, case notes revealed that he had woken up and thrashed on the table during a prior cardiac catheterization procedure, prompting doctors to sedate him before proceeding.
Only when his movements became unmistakable did they abandon the operation. Hoover’s family was told he would never make it home. Today, he’s alive, walking, and living three years post-incident.
It would be more reassuring if Hoover’s story were a one-off nightmare. At a congressional hearing this September, however, transplant surgeon Dr. Robert Cannon described a similar incident outside Alabama to NPR.
As his team prepared for organ retrieval, the anesthesiologist noticed the patient taking an unassisted breath, yet an Organ Procurement Organization representative reportedly encouraged them to proceed. Cannon refused, fearing that removing organs in such circumstances might “murder a patient, ” according to an NPR article.
Given that such incidents have occurred repeatedly, it’s clear that a widespread misunderstanding persists about what “brain death” truly means — one in which “brain death” and “real death” are dangerously conflated.
The term “brain death” was introduced in the late 1960s by an ad hoc Harvard University committee as a way to navigate the ethical and practical challenges of life-support technology.
Brain death, according to Wikipedia, is meant to describe “the permanent, irreversible, and complete loss of brain function, which may include cessation of involuntary activity necessary to sustain life.”
In practical terms, a brain-dead patient shows no signs of consciousness, but their organs remain functional, providing a window of opportunity for transplantation.
Yet a 2008 article in The New England Journal of Medicine revealed that organs harvested from brain-dead individuals come from people who are technically still biologically alive. The article cautioned that the medical profession has gerrymandered the definition of death to fit the needs of organ donation, using it to provide what they call “misleading ethical cover.”
“The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead,” wrote Dr. Robert D. Truog, a physician at Harvard Medical School, and Franklin G. Miller, a bioethicist at the National Institutes of Health.
It’s unsettling, to say the least, to think that definitions in matters of life and death have become flexible to fit the convenience of the organ procurement process.
What’s more troubling is that the ethical grounding that once underpinned medical practice seems to be eroding. With each new layer of technological ability, it seems the ethical guidelines must evolve or else become hopelessly outdated, creating a troubling gap between medical power and moral responsibility.
Unchecking that box on my license, then, is a choice driven by caution and a lack of trust in the ethical judgment behind these procedures.
Most people don’t question the process: they sign on, assuming that death is death, and that their organs will be taken only when they are truly gone. But in a world where definitions shift to accommodate agendas — where “brain death” becomes “good enough” for death — an unchecked box seems like a prudent safeguard against being misclassified.
For now, I’m choosing caution. I’m unchecking that box, not because I don’t believe in the good organ donation can bring, but because in a system where definitions can be manipulated, my life — or death — should not hinge on a flexible interpretation of either.
Isabella Doer is a senior studying English.
