The heart monitor flatlines. The family weeps. The doctors wait exactly 75 seconds—then restart the procedure. In the world of organ transplants, “dead enough” has become a moving target.
The New York Times just reported something most people aren’t ready to hear: in the rush to expand organ transplants, procurement teams have sometimes started too early. Not after death—before it was fully established.
This isn’t just investigative journalism anymore—it’s official. In July, the US Department of Health and Human Services released the results of a federal investigation into the transplant system. Their words, not mine: “Hospitals allowed the organ procurement process to begin when patients showed signs of life, and this is horrifying,” declared HHS Secretary Robert F. Kennedy, Jr. The federal report found that at least 28 patients may not have been dead when organ removal began.
This is happening under a protocol called donation after circulatory death (DCD). It’s fundamentally different from the more established practice of donation after brain death, where patients have irreversibly lost all brain function and are kept on machines only to maintain their organs. DCD patients still have some brain activity—they’re dying, but not yet dead. Doctors determine they’re near death and won’t recover, but that’s a medical judgment call, not biological certainty.
DCD used to be rare. Now it accounts for a huge and growing share of transplants. Every day, 13 people perish waiting for organs that never come. That urgency is real, and it explains why the system feels pressure to expand every possible avenue for donation. But saving lives by potentially taking them prematurely isn’t salvation—it’s a different kind of death sentence.
This is not a debate about whether transplants save lives—they do. It’s about something more fundamental: the line between life and death being treated as a flexible scheduling variable.
Hellbound and Down 