RKF Jr’s other crusade: moral standards for the organ-transplant industry

By Phil Lawler ( bio - articles - email ) | Sep 09, 2025

His crusade against mandatory vaccinations had dominated the headlines, but don’t lose sight of another campaign by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.. Last month he proclaimed that under his leadership, HHS “is overhauling the organ-transplant system. We’ve exposed gross negligence, launched sweeping reforms, and will decertify any organization that violates the sanctity of human life.”

Those last few words—“the sanctity of human life”—should command the attention of Catholic Americans. For that matter, so should RFK Jr’s campaign.

The Catechism of the Catholic Church (2296) teaches that organ transplants “can be meritorious” if the donor gives his consent freely and the benefits to the recipient outweigh the danger to the donor. However, the Catechism goes on: “It is morally inadmissible directly to bring about the disabling mutilation or death of a human being, even to delay the death of other persons.” By those standards the donation of a paired organ, such as a kidney, can be applauded. But the removal of an essential organ, such as a heart, from a living person must be condemned.

Unfortunately doctors have not found a way to transplant human organs from cadavers. Once the blood stops circulating, the condition of organs deteriorates quickly, and they become unsuitable for transplantation. So how can unpaired human organs be obtained for transplants?

In the 1960s a team of physicians and ethicists from Harvard pondered that question, and concluded that “there is a great need for the tissues and organs of the hopelessly comatose” in order to fill the need for transplants. That blunt appraisal, which appeared in a draft of the panel’s conclusions, might have shocked many Americans, and no doubt for that reason it was removed from the final report. Instead the Harvard group introduced the concept of “brain death” as a standard by which patients who were still breathing, and their hearts still beating (albeit perhaps with artificial help) could be declared dead, and their organs harvested for transplants.

Since that time, as transplants (heart transplants in particular) have become more common, the demand for new donors has steadily increased—as has the pressure on organ-procurement networks to furnish the desired organs. The situation has always been ripe for abuse, and recent months have brought three important new developments, each shedding new light on the moral risks involved in transplants.

• Last February, more than 150 Catholic doctors, ethicists, theologians, and others (including myself) joined in a statement decrying new criteria for the diagnosis of “brain death,” saying that they “do not provide moral (prudential) certainty of death.” The statement included a grim warning that “a clear majority of vital organ donors can be presumed alive at the time of organ harvesting.”
• Then in June of this year, a federal investigation uncovered multiple abuses in the work of an organ-procurement network in Kentucky. The investigation found, as reported in the New York Times, that in many cases the procurement team “ignored signs of growing alertness” in dozens of patients who were scheduled to have their organs harvested. In other words the procurement network was preparing to remove a beating heart from a living person.
• The scandal in Kentucky drew attention to the fact that along with the questionable diagnosis of “brain death,” transplant teams were also using the term “circulatory death” to justify a declaration of death in cases when the patient still appeared, by ordinary standards, to be alive. “Circulatory death” was not an entirely new concept, but it now came under fresh scrutiny.

”Circulatory death” is declared when a comatose patient is removed from life-support systems and his heart stops beating. At first glance—setting aside the moral questions involved in removing life support—this looks very much like a classical finding of death. But doctors have found that in some cases, by quickly restoring the flow of blood to the heart, they can restore the heart’s function, making it a candidate for transplantation.

But wait. If the heart can be made to beat properly for a new recipient, why not for the patient from whom it was removed? If his heart could be made to beat properly, why was he declared dead?

And that’s not the only moral problem—in fact not even the most obvious one. A 2023 article in the New York Times, explaining the “circulatory death” concept, explained:

But that may be a minor problem compared to an additional step surgeons take: They use metal clamps to cut blood flow from the revived heart to the donor’s head, to limit blood flow to the brain to prevent the possibility that any brain activity is restored. Some physicians and ethicists say that is a tacit admission that the donor might not be legally dead.

So to obtain a heart for transplantations, the medical team will:

1. Remove a living patient from the artificial support that keeps him alive;
2. Wait until his heart stops, and declare him dead, but
3. Block the flow of blood from his heart to his brain, so that restoration of heart function will not complicate matters by restoring brain function;
4. Restore blood flow to the heart, so that it regains function;
5. Remove the heart from what will then become, beyond question, a cadaver.

Each one of these ghoulish operations is allowed by current medical guidelines. Yet the federal investigators found that even these lax standards have frequently been ignored, in the rush to procure organs for transplantation. Can there be any doubt of the need for restraints on the transplant process: restraints that would reflect a basic respect for the sanctity of human life?