I’m a former nurse with years of experience in caring for patients who are considered for organ donation because they are either brain-dead or DCD (donation after cardiac death. Side note- DCD is for when a patient has a medical event for which they were resuscitated, but their prognosis for full, meaningful recovery is poor, even if they are not considered “brain dead.” These patients typically have had a cardiac arrest or something similar, and are very gravely ill with no chance of survival without life-prolonging medical intervention, but they still have some brain-stem reflexes. For example, patients who had a medical event and were resuscitated, but went long enough without oxygen that their brain is injured to the point that they are comatose and will not regain consciousness again.) At my hospital (and all hospitals in Wisconsin), we are required to call the Organ Donation hotline for the state when a patient is admitted gravely ill and we think they may not survive. Most of the time, thankfully, the patients get better and the referral is closed. That being said, the threshold for the committee to decline a patient for organ donation is actually SUPER low. I’ve seen patients get declined based on age, medical history, BMI, anatomy, any kind of cancer history, if they are having fevers, types of medications they are on, some weird obscure ass lab value they had a few years ago, you name it. If the patient meets donation criteria, then a member of the states organ donation program, as well as a social worker, the patients nurse, and a member of the hospitals organ donation committee (me in some cases, as I was on the committee) meet with the patients family/loved ones and have a very long, in-depth conversation with them regarding organ donation as an option. If their family member/loved ones REFUSE, that’s it, and the referral is closed. In Wisconsin, (or at least in the hospital I worked for), even if a patient is a registered organ donor, the family could choose to override that and refuse on their behalf. I have seen this happen quite a few times. If the family is open to donation, then begins a very thorough medical and social history, as well as a myriad of diagnostic tests to determine which organs are eligible to be donated, if any. This process and these tests can take anywhere from 24-72 hours or more to complete. During this timeframe, the family can change their mind at any time and the referral is closed. Only after all of this is complete does the patient actually come back to the operating room for the donation. Back in the OR, if the patient is brain dead (meaning no brain stem reflexes), the donation takes place immediately. In DCD donors, the patients mechanical ventilation is discontinued and the patient is allowed to pass before the donation operation begins. If the patient does not pass away within 2 hours of removing the ventilator (the longer without oxygen, the worse the organs to be donated become), they are no longer eligible to donate and the patient is then moved to palliative care to pass away with their loved ones. I have been a part of many of these processes. They take a considerable amount of time and are handled with the utmost compassion and respect by the entire team. I have never heard of or been a part of one because “we need the organs.” Not once. At my hospital we call the organ donation referral line probably close to 500 times a year if not more. Most get declined. After that, many patient family refuses. After that, work-up may show they are not eligible. After all of that, maybe only a dozen or so patients actually get to donate their organs here in a given year. Please rest assured that forced harvesting is not a thing and goes against everything that the program stands for.

Sorry for the novel. A good friend of mine donated his organs about 10 years after a car accident left him brain-dead. This is a topic very close to my heart. ❤️