A New York Times opinion piece by three Northwell Health physicians proposes broadening legal criteria for declaring death to increase organ donations. The doctors suggest including irreversibly comatose patients on life support under the definition of death. The move aims to address the severe national shortage of transplantable organs while raising serious ethical concerns.
Cardiologist Sandeep Jauhar, along with Snehal Patel and Deane Smith, argue current definitions recognize death only when brain function ceases entirely—even if the heart continues to beat—or when the heart stops completely, known as circulatory death. They stress that brain death cases suitable for organ recovery are exceedingly rare, citing fewer than 500 annually in New York State. Meanwhile, approximately 15 Americans die daily waiting for transplants.
Op-ed authors propose adopting “normothermic regional perfusion,” a practice used in Europe. This technique preserves organ viability after circulatory death by restoring region-specific circulation temporarily—even though the patient lacks full brain function. The approach, they claim, yields higher quality organs for transplantation.
Critics highlight alarming ethical implications. Critics on Reddit describe the proposal as effectively harvesting organs from patients who may still be conscious, arguing such an expansion could erode consent and trust in medical institutions. One comment stated, “We have a shortage of organs, therefore we need to start harvesting organs from people who would generally be considered alive”. Others assert that expanding definitions of death risks a dystopian slide where economic pressures override the sanctity of life.
Bioethical literature confirms this debate. Medical ethics experts stress that brain death is not identical to biological death. Debate persists about whether irreversible coma should suffice for declaring death, particularly when cutting-edge support technologies blur traditional boundaries.
