The Unseen Cost of Organ Transplants: Ethical Issues and Spiritual Implications

When I first applied for a driver’s license, I was asked if I wanted to designate myself as an organ donor. Given my learned distrust of societal institutions (e.g., medicine) and a few concerning stories I’d come across, I opted to not be an organ donor. However, I also felt quite conflicted about doing so, particularly since I strongly believe in following the golden rule (treat others as you would want to be treated) and knew that if I needed a transplant I would be desperate for the appropriate donor to be willing to give the gift of life to me.

Since that time (when information challenging the mainstream narrative was quite difficult to find), I’ve come across much more information on the topic which paints a rather disturbing but also amazing profoundly paradigm shifting perspective on the topic (e.g., this article will detail the tangible spiritual consequences of receiving an unethically harvested organ). Never Be Sick Again: H... Raymond Francis Check Amazon for Pricing.

However, due to my inherent conflict over this topic (e.g., many people need organs so I don’t want to discourage donations—particularly since organ shortages cause even more unethical steps to be taken to procure organs), I focused on other topics and only started this article in July. To my great surprise, a few weeks later, RFK Jr. did something I never anticipated and formally announced that there were widespread failures of the ethical safeguards in our organ donation system, after which, the Overton window was blown open and others (e.g., the head of the Independent Medical Alliance) began discussing the grim reality organs were being taken from still living people.

The Value of Organs

I have long observed that as long as enough money is on the line, there always will be a portion of people who are willing to do horrific and unimaginable things (e.g., slaughter people in overseas wars for profit). As such, I always consider the actual incentives at work when trying to appraise the reality of worrisome situations I come across.

One of the great accomplishments of the medical system was it creating the mythology it could conquer death, after which it gradually pivoted to being viewed as essential for remaining alive, and then to something which was necessary to continuously consume for “health”—all of which allowed it become incredibly profitable (and consume an ever increasing share of America’s GDP—currently totaling over 17.6% of all money spent in the United States).

Note: Medical Nemesis was an insightful 1976 book which predicted much of what followed. In Chapter 5 (pages 64–77—which can be read here), Ivan Illich highlights how the cultural conception of death evolved from an intimate, lifelong companion we had no separation from to a feared, medicalized entity to be conquered. He traced this shift through six historical stages, from the Renaissance ‘Danse Macabre’ to modern death under intensive care, where death is defined by the cessation of brain waves.

Illich argued that this medicalization, driven by the medical profession’s growing control, stripped individuals of autonomy, turned death into a commodity, and reinforced social control through compulsory care. This Western death image, exported globally, then supplanted traditional practices, contributing to societal dysfunction by alienating people from their own mortality. I agree with this, but feel the impacts of this were far more profound than even Illich hinted at.

In tandem with this, medicine began performing medical “miracles” such as being able to raise the dead (via cardiac resuscitation) and transplant organs. Opening the previously insurmountable boundaries between life and death, in turn, earned the discipline immense credit in the eyes of the public, and hence allowed it to justify being paid obscene amounts for its services (whereas in the past, doctors were paid very little and frequently only if they were able to get others better).
Note: as I will discuss in this article, crossing that boundary also called into question the materialistic (non-spiritual) paradigm modern science rests upon.

Because of this, coupled with how limited viable donor organs are, transplants rapidly became an incredibly valuable commodity (e.g., the cost of a transplant ranges from $446,800 to $1,918,700 depending on the organ—with the heart being the most expensive). As such, given how desperate many are for the organs, and how much money is at stake, it felt reasonable to assume some degree of illegal organ harvesting would occur given that people are routinely killed in other contexts for profit (e.g., in overseas wars, with a pharmaceutical company pushing lucrative drug they know can kill, or the brutal cartel violence done to establish territory).

Over the years, I then found various pieces of evidence suggesting this was happening, the worst of which I was unsure if they indeed transpired. As this is disturbing, you may want to skip the rest of this section. These included:

•Individuals being tricked into selling a kidney (e.g., in 2011, a viral story discussed a Chinese teenager who did so for an iPhone 4—approximately 0.0125% of the black market rate for a kidney, after which he became septic and his other kidney failed leaving him permanently bedridden and in 2023, a wealthy Nigerian politician being convicted for trying to trick someone into donating a kidney for a transplant at an English hospital).

•A 2009 and 2014 Newsweek investigation and a 2025 paper highlighted the extensive illegal organ trade, estimating that 5% of global organ transplants involve black market purchases (totaling $600 million to $1.7 billion annually), with kidneys comprising 75% of these due to high demand for kidney failure treatments and the possibility of surviving with one kidney (though this greatly reduces your vitality). Approximately 10-20% of kidney transplants from living donors are illegal, with British buyers paying $50,000–$60,000, while desperate impoverished donors (e.g., from refugee camps or countries like Pakistan, India, China and Africa), receive minimal payment and are abandoned when medical complications arise, despite promises of care. To quote the 2009 article:

Diflo became an outspoken advocate for reform several years ago, when he discovered that, rather than risk dying on the U.S. wait list, many of his wealthier dialysis patients had their transplants done in China. There they could purchase the kidneys of executed prisoners. In India, Lawrence Cohen, another UC Berkeley anthropologist, found that women were being forced by their husbands to sell organs to foreign buyers in order to contribute to the family’s income, or to provide for the dowry of a daughter. But while the WHO estimates that organ-trafficking networks are widespread and growing, it says that reliable data are almost impossible to come by.

Note: these reports also highlighted that these surgeries operate on the periphery of the medical system and involve complicit medical professionals who typically claim ignorance of its illegality (e.g., a good case was made a few US hospitals like Cedars Sinai were complicit in the trade).

• A 2004 court case where a South African hospital pled guilty to illegally transplanting kidneys from poorer recipients (who received $6,000–$20,000) to wealthy recipients (who paid up to $120,000).^1,2

• Many reports of organ harvesting by the Chinese government against specific political prisoners.^1,2,3,4,5,6 This evidence is quite compelling, particularly since until 2006, China admitted organs were sourced from death row prisoners (with data suggesting the practice has not stopped).
Note: harvesting organs from death row prisoners represents one of the most reliable ways to get healthy organs immediately at the time of death.

• Over the years, I’ve read allegations Israel illegally harvested organs from murdered Palestinians.^1,2,3 I have never known what to make of these, as while some of the evidence appears compelling, neither the sources nor the evidence are definitive (often coming from those politically opposed to Israel), and logistically, collecting organs from someone who was just murdered on the battlefield before the organ expires is very difficult (and would require a specialized harvesting team to be there—something I’ve never seen reported). However, it has been officially admitted longer lasting tissues (e.g., corneas) were harvested without consent from Israelis and Palestinians bodies until the practice was banned in the 1990s.
Note: I’ve also read reports of organ harvesting occurring in Middle East conflict zones, by ISIS and in the Kosovo conflict, and with drug cartels.

Given all of this, I am unsure of the extent of “unethical” organ harvesting, but I am sure it happens (including in the most horrific manner we can imagine) and that there are likely far more cases of which have been successfully swept under the rug. Simultaneously, I strongly suspect the state sanctioned form has gradually decreased as more awareness was brought to the problem (however this may be counterbalanced by the blackmarket as the demand for organs continues to increase).

Note: many other valuable tissues (e.g., tendons and corneas) can be harvested from dead bodies. Significant controversy also exists with the ethics of how these are collected (e.g., the respect given to the bodies or how profit focused that industry is). As there is less oversight with these transplants, a significant amount of questionable conduct is rarely reported, but as the primary ethical concerns are not applicable (e.g., harvesting from a non-consenting living donor), this topic will not be discussed in this article.

Locked-In Syndrome

Since so many different parts of the brain control different facets of our being, individuals who are still conscious can sometimes completely lose control of their bodies or the ability to community with the outside world (termed Locked-in syndrome).

In one famous case, Martin, a 12-year old who fell ill with meningitis entering a vegetative state, was sent home with his parents to await his death, but instead remained alive and was brought by his father to a special care center at 5 am each day. When he turned 16, he began regaining consciousness, by 19 became fully aware of everything around him, then gradually regained some control of his eyes, and at 26 (long after he’d become a background object), a caregiver realized he was showing signs of awareness, at which point he was tested, giving a communication computer, and gradually regained his functionality (eventually getting married).

Note: two aspects I never forgot from his memoir were the years he spent being haunted by his exasperated mother (without thinking) once saying “I hope you die” and him sharing “I cannot even express to you how much I hated Barney” as the care center he spent years at, assuming he was vegetative, had him watch Barney the Dinosaur re-runs each day.

Since our ability to perceive and interact with the world depends upon many different regions of the brain, those capacities also fade as one is nearing death. However, rather than being a random process, certain functions are lost before others. In turn, it’s frequently observed within the palliative medical field (where support is offered to dying individuals) that touch and hearing are the last two senses to disappear (e.g., this study showed hearing is preserved at the end of life). As such, I often think of Martin’s story (with people who are assumed to be unaware of their environment) and periodically tell grieving families there is a possibility their “brain dead” (or soon to die) loved one can either hear their voice or feel their touch as this often provides a significant degree of closure for them (and every now and then I hear a story suggesting that final communication was perceived).

Note: a strong case can be made that modern medicine functions as the state religion of our society (with many of its rituals and behaviors having strong parallels to what was seen in other religions such as doctors’ white coats being equivalent to a priest’s robes or vaccines being its holy water you are baptized in). Cardiac resuscitation (“raising the dead”) likewise is a powerful miracle which many have argued helped cement our modern faith in medicine. What’s less recognized (as it challenges science’s spirit-denying dogma that insists consciousness resides solely within the brain) is that many resuscitated individuals have had replicable “near death experiences” where they were aware of their surroundings (often from outside their body) when their brain was “dead.” This is turn suggests that other “less recognized” senses may also persist at the time of brain death.

In parallel, while rare, every now and then cases occur when “dead” people come back to life (e.g., a Mississippi man who’d been in a body bag for a while woke up right before being embalmed—and numerous other cases exist of someone declared dead by multiple physicians later waking up^1,2,3).

The Specificity of Brain Death

Sensitivity designates being able to spot something that is there while specificity designates not erroneously spotting something which wasn’t actually there (a false positive). In most cases, it is impossible to have perfect sensitivity and specificity, as once you increase one, you inevitably decrease the other (e.g., tough on crime approaches reduce crime but also inevitably result in innocent people being arrested and convicted).

This concept is typically looked at with medical diagnoses (e.g., not missing a cancer that is there but also not erroneously diagnosing a cancer and putting someone through a harmful and unnecessary cancer protocol—which for example is a common issue with routine screening mammograms), but also applies to many other fields to. In turn, I believe many issues in society boil down to finding the best possible balance between the two, but frequently, issues become polarized and irreconcilable as neither side is willing to consider the other (sensitivity or specificity) or alternately, only one side is publicly presented and we never hear about the other (e.g., we are constantly told about the dangers of not vaccinating and catching diseases but rarely if ever about the far more frequent injuries that result from vaccination).

Since organs rapidly lose their viability once someone dies, the only consistent way to ethically obtain them is from someone who has already “died” but whose body is still keeping the organs alive—in other words, from someone who is brain dead.

Given that the potential exists for individuals who are brain dead to still be alive (e.g., consider the examples I just provided) and how much money is on the line for transplants, this naturally led me to wonder if the specificity of that diagnosis might have been lowered to meet the needed quotas.

For example, The New York Times published an essay two weeks ago advocating for increasing the sensitivity for detecting brain death which many understandably found quite disturbing. To quote it:

Donor Organs Are Too Rare. We Need a New Definition of Death.

A person may serve as an organ donor only after being declared dead…Brain death is rare, though.

The need for donor organs is urgent. An estimated 15 people die in this country every day waiting for a transplant.

New technologies can help. But the best solution, we believe, is legal: We need to broaden the definition of death.

Fortunately, there is a relatively new method that can improve the efficacy of donation after circulatory death. In this procedure, which is called normothermic regional perfusion, doctors take an irreversibly comatose donor off life support long enough to determine that the heart has stopped beating permanently — but then the donor is placed on a machine that circulates oxygen-rich blood through the body to preserve organ function. Donor organs obtained through this procedure, which is used widely in Europe and increasingly in the United States, tend to be much healthier.

But by artificially circulating blood and oxygen, the procedure can reanimate a lifeless heart. Some doctors and ethicists find the procedure objectionable because, in reversing the stoppage of the heart, it seems to nullify the reason the donor was declared dead in the first place. Is the donor no longer dead, they wonder?

Proponents of the procedure reply that the resumption of the heartbeat should not be considered resuscitation; the donor still has no independent functioning, nor is there any hope of it. They say that it is not the donor but rather regions of the body that have been revived. The Reverse Aging Powe... Harmon, Dr. Jon Check Amazon for Pricing.

How to resolve this debate? The solution, we believe, is to broaden the definition of brain death to include irreversibly comatose patients on life support. Using this definition, these patients would be legally dead regardless of whether a machine restored the beating of their heart.

So long as the patient had given informed consent for organ donation, removal would proceed without delay. The ethical debate about normothermic regional perfusion would be moot. And we would have more organs available for transplantation.

Apart from increased organ availability, there is also a philosophical reason for wanting to broaden the definition of brain death. The brain functions that matter most to life are those such as consciousness, memory, intention and desire. Once those higher brain functions are irreversibly gone, is it not fair to say that a person (as opposed to a body) has ceased to exist?

In 1968, a committee of doctors and ethicists at Harvard came up with a definition of brain death — the same basic definition most states use today. In its initial report the committee noted that “there is great need for the tissues and organs of the hopelessly comatose in order to restore to health those who are still salvageable.”

This frank assessment was edited out of the final report because of a reviewer’s objection. But it is one that should guide death and organ policy today.

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