To: Members of the United States Congress and Relevant Federal Health Oversight Agencies

 

We, the undersigned, call for immediate reform of federal organ procurement policies that currently allow — and in practice require — hospitals to contact Organ Procurement Organizations (OPOs) upon every death, regardless of whether the deceased individual was a registered organ donor.

Under current federal regulations, once an OPO is notified, representatives may contact surviving family members to request organ donation. In many cases, this occurs even when the deceased clearly did not register as an organ donor. Families who decline are often subjected to repeated follow-ups, emotional pressure, and guilt-based persuasion during the most vulnerable moments of their lives.

This practice is harmful, unethical, and inconsistent with the fundamental American principle of expressed consent. 

Organ donation in the United States is based on opt-in consent.
When an individual chooses not to register as a donor, that decision should be respected in death.
Current procedures allow OPOs to bypass the expressed wishes of the deceased by placing the burden on grieving families to “override” a choice that was already made.
Families are contacted immediately after death, often while still in shock, and asked to make irreversible decisions under emotional duress.
Many families report feeling harassed, pressured, or morally shamed after saying no — a practice that retraumatizes people at their lowest point.
 

Grief is not a sales opportunity. A hospital room is not a negotiation table. 

We fully support ethical, voluntary organ donation. What we oppose is a system that:

Disregards the autonomy of individuals who did not consent
Exploits families during acute grief
Treats donation as an outcome to be pursued rather than a choice to be respected
 

When consent is not given in life, it should not be pursued in death.

 We Call for Federal Reform That:
 Prohibits OPO contact with families when the deceased was not a registered organ donor, unless the family initiates the conversation themselves.
Affirms that non-registration is a valid and final expression of refusal, not a neutral default to be overridden.
Establishes clear limits on OPO communication, including bans on repeated or coercive contact after a family declines.
Creates accountability and oversight mechanisms for complaints from families who experience harassment or pressure.
Centers grief-informed care, ensuring families are given space, dignity, and respect.

Families deserve the right to mourn without being pursued, persuaded, or made to feel guilty for honoring their loved one’s wishes. Respect for bodily autonomy does not end at death. A system built on compassion must not sacrifice humanity in the name of efficiency or profit.

Let families grieve.

Let expressed consent mean something.

Let death be met with dignity, not pressure.

 

We urge lawmakers to act now to end this practice and protect grieving families across the United States.