Organ donation group accused of trying to take living man’s organs faces shutdown

因涉嫌试图摘取活人器官，美国器官捐献组织面临关停

The US health department is working to shut down a Kentucky-based organ procurement organization that made headlines over a 2021 incident in which it was accused of trying to harvest a man’s organs while he was still alive. 美国卫生部正致力于关停一家位于肯塔基州的器官获取组织。该组织曾因2021年的一起事件登上新闻头条，当时它被指控试图在一名男子仍然活着的情况下摘取其器官。

In an announcement Wednesday, the Department of Health and Human Services said it had begun the process to decertify the organization, Network for Hope (NFH). Losing its certification would effectively shutter the organization, which serves Kentucky as well as parts of Indiana, Ohio, and West Virginia. If decertified, another organization will be appointed to coordinate donations in the region. 美国卫生与公众服务部（HHS）在周三的一份公告中表示，已启动取消该组织“希望网络”（Network for Hope，简称NFH）认证的程序。一旦失去认证，该组织将不得不关停。该组织的服务范围覆盖肯塔基州以及印第安纳州、俄亥俄州和西弗吉尼亚州的部分地区。如果认证被取消，将会有另一个组织被指派负责该地区的捐献协调工作。

In a statement, NFH said it “strongly disagrees” with the HHS’s finding and will appeal the decertification decision. HHS said its decision stems from two federal investigations of NFH that found “persistent patient safety failures,” despite extensive oversight and opportunities to correct failures. NFH在一份声明中表示，其“强烈不同意”HHS的调查结果，并将对取消认证的决定提出上诉。HHS表示，其决定源于对NFH进行的两次联邦调查，调查发现尽管经过了广泛的监管并提供了纠正错误的机会，该组织仍存在“持续性的患者安全失误”。

The two investigations were carried out separately by the HHS’s Centers for Medicare & Medicaid Services and the Health Resources and Services Administration (HRSA). The HRSA investigation, which concluded last year, examined 351 NFH cases in which organ donations had been authorized but were ultimately canceled. In 103 cases, investigators found “concerning features,” including 73 cases in which patients had neurological signs that should have made them ineligible for organ donation. 这两项调查分别由HHS下属的医疗保险和医疗补助服务中心（CMS）以及卫生资源和服务管理局（HRSA）进行。去年结束的HRSA调查审查了351起NFH经授权但最终取消的器官捐献案例。调查人员在其中103起案例中发现了“令人担忧的特征”，包括73起案例中，患者表现出的神经系统体征本应使其不符合器官捐献的条件。

The scrutiny over NFH and other organ procurement organizations comes amid increases in donations from people who have had circulatory deaths (their heart stops), rather than those who have been declared brain-dead. Donation after circulatory death often occurs when patients are not expected to make a recovery and a family decides to withdraw life support. Organ procurement organizations cannot declare a person dead and are barred by law from being involved in care decisions. However, deciding when to remove life support is not clear-cut. 对NFH及其他器官获取组织的审查，正值循环死亡（心脏停止跳动）捐献者数量增加之际，而非传统的脑死亡捐献者。循环死亡后的捐献通常发生在患者预计无法康复且家属决定撤除生命支持的情况下。器官获取组织无权宣布患者死亡，法律也禁止其参与医疗护理决策。然而，决定何时撤除生命支持并非易事。

Horror story

恐怖故事

NFH made headlines when reports surfaced about a 2021 incident in which a Kentucky man in his 30s began visibly crying, pulled his knees to his chest, and shook his head as he was wheeled into surgery to have his organs harvested. The man, Anthony Thomas Hoover II, had overdosed and had been unresponsive for two days before his family agreed to donate his organs, believing he would not recover. 2021年发生的一起事件让NFH登上了新闻头条：一名30多岁的肯塔基州男子在被推入手术室准备摘取器官时，开始明显哭泣、蜷缩双膝并摇头。这名男子名叫安东尼·托马斯·胡佛二世（Anthony Thomas Hoover II），他因药物过量昏迷了两天，家属在认为他无法康复的情况下同意捐献其器官。

But as the organ retrieval nears, he began showing signs of improvement, which allegedly went ignored by organ procurement workers while making the hospital staff deeply uncomfortable. NFH’s predecessor organization, KODA, allegedly pressured hospital staff to move forward with the organ donation. When Hoover was brought into the operating room clearly responsive, doctors involved in the organ retrieval refused to move forward and remove life support. 但在器官摘取手术临近时，他开始出现好转迹象。据称，器官获取工作人员无视了这些迹象，这让医院工作人员感到极度不安。NFH的前身组织KODA据称曾向医院员工施压，要求继续进行器官捐献。当胡佛被推入手术室且表现出明显的反应时，参与器官摘取的医生拒绝继续手术并撤除生命支持。

One worker, Natasha Miller, told NPR that a KODA supervisor was on the phone at the time, demanding that employees find another surgeon who would agree to carry out the retrieval. The surgery was canceled, and Hoover recovered, though he has lingering neurological injuries. His sister appeared at a press briefing Wednesday announcing the US health department’s efforts to decertify NFH. 一名工作人员娜塔莎·米勒（Natasha Miller）告诉美国国家公共电台（NPR），当时一名KODA主管正在通话中，要求员工寻找另一位愿意执行摘取手术的外科医生。手术最终被取消，胡佛得以康复，尽管他留下了持续的神经系统损伤。他的姐姐周三出席了新闻发布会，宣布了美国卫生部取消NFH认证的举措。

In a statement, NFH said it complies with all federal organ policies and, since the incident, implemented a “pause” process that allows anyone involved in a case—from family to health care providers—to pause donation plans if concerns arise. The state of Kentucky subsequently wrote the pause process into law. NFH在声明中表示，其遵守所有联邦器官捐献政策，并自该事件以来实施了一项“暂停”程序，允许任何参与案例的人员（从家属到医疗服务提供者）在出现疑虑时暂停捐献计划。肯塔基州随后将这一暂停程序写入了法律。

More than 103,000 people are on the US organ transplant waiting list, and there were more than 49,000 transplants last year. 目前美国有超过10.3万人处于器官移植等待名单上，去年共进行了超过4.9万例移植手术。