The Erosion of Ethics in Modern Transplant Medicine | Dr. Joseph Varon

[RUSH TRANSCRIPT BELOW] In 2024, more than 48,000 organ transplants were performed in the United States.

However, as Dr. Joseph Varon, president of the Independent Medical Alliance (IMA), writes in his recent article “The Moral Cost of Modern Transplant Medicine”: “That number should inspire hope—but instead, it invites scrutiny. A substantial portion of those organs were harvested under ethically ambiguous conditions. … The line between patient and donor is blurring.”

Health Secretary Robert F. Kennedy Jr. has recently vowed reform after finding some hospitals were overly hasty in proceeding with organ procurement from donors even “when patients showed signs of life.”

Varon is a critical care physician who has authored more than 980 peer-reviewed publications. He has been a critic of current organ transplant practices in America and has been warning about what he sees as a shift away from foundational medical ethicssuch as informed consent, dignity, and the sanctity of human life.

I sat down with Varon to find out what exactly is going on inside America’s modern transplant system: Is it true that some donors are not brain dead when the organ extraction process is initiated? Is the waitlist and distribution process truly based on need—or are there ways to jump the line? And is it the case that transplant teams are often called in so early—sometimes when the donor is still alive?

“Many people—instead of thinking ‘how are we going to try to save this person’—start calling the transplant team ahead of time. So the person is not even dead, and you’re already calling the transplant team,” Varon says.

How can we uphold the rights of donors while also meeting the urgent needs of patients whose lives depend on an organ transplant?

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

RUSH TRANSCRIPT

Jan Jekielek:

Dr. Joseph Varon, such a pleasure to have you back on American Thought Leaders.

Dr. Joseph Varon:

Thank you for having me back.

Mr. Jekielek:

We’re here at this Brownstone Institute event at a beautiful place called Polyface Farms, but today we’re going to talk about something a little morbid. What caught my attention was your piece for Brownstone Institute, The Moral Cost of Transplant Medicine. Please explain to us why you felt compelled to write this piece.

Dr. Varon:

Throughout my medical career, I have been confronted with patients who need transplants, patients who have complications from transplants, and it’s something that has been close to my heart. Having said that, I have also seen the evil side of transplantation. I have seen organizations that supposedly are entitled to tell you who can be transplanted and who cannot be transplanted on the basis of criteria. And how can those criteria be jumped? They are jumped on the basis of money. 

Mr. Jekielek:

So you mean like every single transplant needs to go through an ethical procurement checklist, like there are very rigorous standards. You’re saying these standards aren’t being followed. 

Dr. Varon:

There are a lot of things that have not been followed. So yes, in order to undergo a transplant, you need to get on a transplant list. The transplant list assigns you when you are going to get your transplant on the basis of how sick you are or how soon you need it. The problem is that what I have seen throughout the years of practicing medicine in the United States is that sometimes these lists get jumped. Maybe somebody who comes from Saudi Arabia and gives a big donation to a hospital gets their transplant before someone local is able to get it. 

Just recently in Houston, for example, one of the hospitals in Houston stopped their entire transplantation program because they found out that there were a lot of under-the-table dealings going on. Can you imagine that? IPeople who have been waiting for years to get a transplant or people who are on their deathbed really requiring a transplant, that they don’t get it because the surgeon or the hospital or somebody decided that they would rather take this one because this one gives them some economic advantage.

Mr. Jekielek:

How many times have you seen that in your own career?

Dr. Varon:

Oh, many, many times. I’ve had them; you have no idea. I remember I used to have this patient of mine who was an Italian gentleman who had a pulmonary condition, but he needed a kidney transplant. He was 72 years of age. I remember telling him, I’m sorry, you cannot get the kidneys because your lungs are pretty bad. And the guy says, doctor, just leave it to me. Just tell me what size kidney I need. I’ll get it for you. Just like that. I’m serious.I don’t know where he was going to get it. I don’t know if it was going to be in China or India. 

Now, having said that, I have seen multiple locations where a person supposedly was dead and, by definition, you know, brain dead. If you are brain dead, you don’t need any permission from anybody to disconnect somebody from a machine or stuff like that. But there are specific criteria as to what constitutes a patient that is brain dead. So, a brain-dead person, for example, would not have any feeling. 

When I was doing my fellowship training, every time there was a potential organ harvest, I would fly with a cardiothoracic surgeon to wherever the person was, so we would examine the lungs. If the lungs were good, then we could get the lungs out. In order to do that, I would do a procedure called bronchoscopy, where you put a scope into the lungs, and if you are dead, you don’t cough, you don’t move, you don’t do anything. 

So, there were more than one instance where I would go in, I would put in my little scope, and the patient would start either moving or coughing. And you look at the nursing staff and you say, hey, this person is not dead. What are you talking about? And what did they say? Well, our neurologist said that the EEG [electroencephalogram] had a flat line. 

Look, there are specific criteria. You have to have total cessation of blood flow to the brain. We now have a variety of different ways by which we can identify brain death, but it needs to be corroborated by two clinicians. I mean, you cannot just be jumping the gun. And that’s one of the problems that’s happening. 

You have critically ill patients, and the nurses will come and tell you, shall we start calling the transplant team? The person is not dead, and they’re already telling you. And that is in depth into many of the policies because, believe it or not, one of the evaluations by CMS and some of these other federal companies is by whether or not you follow the guidelines, and one of the guidelines is that for every person that dies in the hospital, you have to call the transplant team—everybody, no matter whether you are a donor or not a donor, everybody—you have to call it up, and the problem is that many of these hospitals are doing it here, the game. 

The person is not dead yet; the person has not been declared dead, but you already have somebody that comes in. And I hate to do the analogy, but these people are salivating, you know? And I remember many of the nurses would come and tell us, hey, the vultures are coming in because they are just salivating to see what organ we can get out of this person.

Mr. Jekielek:

There are a lot of people that die waiting for organs. So you can sort of imagine people wanting to be able to find good organs that are going to hold, you know, that are going to work for the patient who’s going to die otherwise. Of course, the way you’re characterizing it sounds very macabre, but I can kind of see it, you know, from the perspective of someone who’s saying, hey, look, if someone is dead, we don’t want to have to cut through too much red tape if they’re really, if they’re actually dead. Let’s just get those organs and save another life, right?

Dr. Varon:

Yes. But again, I mean, there you have the problem: have they truly been declared? That’s the biggest concern that we have. Why are we jumping the gun? And please don’t misunderstand me. I’m a big supporter of organ transplantation. I’m a true believer that organ transplants can make a big difference in people.

But it needs to be done right. You need to put the patient first. Which patient? The patient that is about to either die or not die. That’s the one that goes first. Because if that person is not truly dead, the only thing that you’re doing is having a huge ethical violation.

Mr. Jekielek:

Of course. I mean, of course. Well, so let me ask you this. As someone who’s a big supporter of organ transplantation, done right, there was a recent op-ed in the New York Times where two doctors suggested that we kind of change the definition, the way to make sure there are more organs available for procurement, that we kind of shift the definition of death somewhat. Did you read this and what’s your reaction?

Dr. Varon:

When you have working critical care like I have, you see things that you say, no, this is not possible that it happens. But I have seen people that have been, quote, declared dead, and they come back to life. I have seen that with my own eyes. Years ago, Dr. Paul Marik called me and said that he had a young woman who had overdosed on a variety of drugs. They gave her CPR for two hours. The chief of neurology came in, saw her, and said, this woman is brain dead, and called the organ transplant team. 

At that time, Dr. Marik called me and said, Joe, can we do that thing that you do for hypothermia? I said, yes, let’s call her. So we called the patient. Now, the machine had malfunctioned, and she had gotten really, really cold. Three days later, she was texting her boyfriend that she didn’t really want to kill herself.

Mr. Jekielek:

Wait, what happened between you calling her and her texting back?

Dr. Varon:

We rewarmed her, and she survived. We published that paper, and that paper actually landed my friend in a not-so-nice confrontation with the chief of neurology. The neurologists have come in, and have seen the patient. We actually published a paper with a note that says that this patient is out. We need to get the transplant team to come and see her. This woman survived. And I have seen that, not once, but multiple times. 

Now, can I tell you everybody’s going to survive? No, of course not. But sometimes it happens. So nobody’s dead until you meet this specific criteria. Changing the criteria to get more organs, I have an issue with it because I don’t think it’s ethically sound. 

Mr. Jekielek:

Give me, just give me a little bit about your background so people can kind of understand, like, why you might have seen so many patients in this situation.

Dr. Varon:

By training, I have six different specialties. Intensive care is one of them, so I have seen so many people at the brink of death. I’m also an emergency room doctor, internal medicine doctor, pulmonary doctor. I mean, I have seen this over and over again. I have run intensive care units all over the place. And I have seen the good, the bad, and the ugly of the transplantation system. 

I have seen amazing situations where people truly require an organ, and you give it to them, and you basically are giving them a new life. But I also have seen these situations where people get too jumpy in their conclusions, and they want to get organs ahead of time. 

I can tell you the times when I was a fellow and we had somebody who was critically ill; instead of thinking about how we are going to try to save this person, the first thing that you are told is to start calling the transplant team ahead of time. So the person is not even dead, and you’re already calling the transplant team so that they can be evaluated to see if they are good organ transplantation candidates.

Mr. Jekielek:

What happened in these situations where you did the scope into the lungs, and the person is coughing. How did people react?

Dr. Varon:

Everybody was impressed. They said, no, that’s not possible. I said, but it’s happening.

Mr. Jekielek:

Then what happened next?

Dr. Varon:

We got back to where we came from. There is no way we were going to be doing that. And the problem is that, you know, there are some cases, like the ones that you were mentioning, where they actually proceeded to do the harvesting on people who were having some kind of reaction in the operating room. A brain-dead person is out. 

No matter what you hit them with, no matter what you cut them with, they have no sensation whatsoever. There is no communication between the organs and the brain. The brain is out. That’s the definition of being dead.

Mr. Jekielek:

It’s incredible. So, you know, why I’m thinking about this, most recently there was this hot mic moment with Xi Jinping and Vladimir Putin, where they talk about, you know, extending lifespan, perhaps towards immortality, you know, using continual organ transplantation. Vladimir Putin says something about this. Xi Jinping responds, perhaps to 150 years, right? So they’re talking about organ procurement. 

And this is in the context of my own reporting on this forced organ harvesting industry in communist China, where, in the transplant literature, researchers in the American Journal of Transplantation found at least 70 examples of papers where in the methods it has been written that the dead donor rule has been violated. It’s very clear in the research methods that people have been killed by the actual organ extraction itself. So when I saw it, I mean, I’m thinking about this. I’m actually writing a book on it as we speak. And suddenly, Dr. Joseph Varon, The Moral Cost of Transplant Medicine.

Dr. Varon:

Yes. The problem is what I consider a contagious problem. We are getting infected with some of these bad behaviors that are happening in China, where people are getting harvested without being dead. And that’s not right. Now, we are seeing that same consideration being sent to us. One of the original cases that gave us an idea that there was something really wrong happening in communist China. 

There was a transplant surgeon named Jacob Lavee, who was actually the former head of the Israeli Transplant Association. They have socialized medicine there. They will pay fully for someone to get an operation outside if they can’t get it done there. So the guy’s waiting. He had a very serious condition; he maybe was going to die. 

So he tells Jacob, his doctor, he says, look, I’ve managed to find something in China. In two weeks, I’m going in. I scheduled my heart transplant. And Jacob says, well, that’s impossible. There’s no way you can schedule a heart transplant. But the guy goes, gets his heart, and comes back. And that’s when Jacob realized that something was wrong. 

Mr. Jekielek:

But so, when you hear this story, what do you think of?

Dr. Varon:

It’s like they have somebody that was ready to be executed and then they take his organs, basically butchering him. This is something that really makes me sick. That’s a problem, because we all have heard about somebody that goes out with a cute-looking woman and comes back without a kidney and things like that. We’ve heard about that. But this is beyond that. This is not just removing one little organ or two organs. These are people that are actively being euthanized in order to get an organ, and more importantly, for money. 

Mr. Jekielek:

There was a piece in the Baltimore Sun recently by Armstrong Williams looking at this, because this is when Secretary Kennedy, announced that there was at least one organ system in Kentucky that was violating the ethical procedures that are essential to having a proper transplantation system, and that they’re evaluating the whole thing. What Armstrong wrote in response was, well, this is the cost of engaging with a system where there’s industrial-scale forced organ harvesting from prisoners of conscience. 

Please tell us about your organization that you run, the Independent Medical Alliance [IMA], one of my favorite medical organizations in America. I’ve been learning from so many of your doctors, part of the reason I got to know you. Just tell me a little bit about what makes your organization different, where your vantage point comes from, and where your outlook on medicine comes from.

Dr. Varon:

First of all, you have people that are actually on the front lines. That’s different. That’s how we started as front line doctors, initially dealing with COVID, but now we deal with everything. So we have firsthand experience on what’s going on in the trenches. So that’s very, very important. 

Second, we do advocacy, but we do advocacy based on science. So we don’t just go out there and start screaming to the world that everything is bad and stuff like that. It’s like, yes, we scream to the world, but we back that up with science, science that we produce, as well as science that we study and learn. 

One of the beauties of the Independent Medical Alliance is that we have a network of trusted physicians, a network of people that we trust who are experts in each one of their fields that we can talk to. One thing that you will see about the Independent Medical Alliance, first of all, we are a 501(c)(3) corporation, so there is no economic incentive or anything for us; we put patients first over any kind of profit. That’s the most important thing as an organization. 

We will help educate people to learn the good, the bad, and the ugly of each one of the different interventions, illnesses, and things like that. You are talking about transplants now. But we can be talking about serotonin antagonists for depression. We can be talking about the pandemic of obesity, which is going on, and it’s a huge problem. 

We are trying as best as we can to give people an alternative by providing them with information, by providing them with a list of people that they can trust, education, education, education. And we’re hoping at some point in time to have a seat at the table with a big voice so that at least they listen to our concerns about what we think is going on. 

Mr. Jekielek:

So, okay, let’s go back to this, you know, the paper that caught my eye, your piece. What is the moral cost? 

Dr. Varon:

The moral cost is huge. I mean, just think about it. Anybody that has in their driver’s license a little heart that says that you are a donor, let’s put it this way, from my standpoint, they can have a premature death. Why? Because somebody may jump the gun earlier. Again, be a donor. I’m not telling you not to be a donor, but be a donor when you truly need to be a donor. 

We are going to start to have more systems. And maybe we need to come up with a very strict new definition of brain death that’s going to have to have not two doctors and this test done. Maybe you don’t have to have three more other tests or things like that so that you can actually say this person is truly dead. Now we can proceed.

Mr. Jekielek:

Well, and so the thing that concerns me when I hear about this stuff, right, this is the type of thing that the Chinese Communist Party excels at in Communist China. They’ll say, well, look, Dr. Joseph Varon says that, you know, Americans are, you know, prematurely getting organs. That’s not really all that different from what we do over here. 

Now, of course, what they do over there is unlimited on-demand organs available from prisoners of conscience forever, you know, and for big money, for elites, for people that have the cash and so forth. But it’s actually a completely different thing in my view, and probably most people’s view, because it’s state-sanctioned. 

However, they’re going to want to use the fact that we’re finding these own problems among ourselves and being transparent about them. And I thank Secretary Kennedy for doing that. And I thank you for basically talking about these things on camera here. But at the same time, I’m almost apprehensive to have this interview because of that, because someone’s going to come out and say, hey, look, it’s the same thing.

Dr. Varon:

Yes, but again, we’re getting infected with what they’re doing, and that’s not right. And we need to come up with a way to make things right. This imbalance of the number of organs that you need and the number of organs that are available is real. There is no question about it. We need transplants, yes, we need a lot of them. 

Maybe we need to spend more money and more resources looking at transplants from animals. They’ve been working a lot on the pig hearts and pig kidneys. They’ve been doing a lot of stuff or come up with an artificial organ. They’re trying to. So maybe we need to work more into that and less on the Machiavelli department that we’re talking about.

Mr. Jekielek:

What would you say is the most important thing we can do right now as a starting point to get this whole, I don’t know, let’s call it a slippery slope that we’ve gone down under control?

Dr. Varon:

What I would do is first, I would revise the protocols for when we call organ transplant, how we call organ transplant, and who is eligible for an organ transplant. That would be the first thing that I would do. And I would make them uniform throughout the U.S. I would make sure that there is no difference between this hospital and that hospital. We need to advocate for patients, put patients over profits. And it seems that in some of these other places, you know, profits go first, patients go second.

Mr. Jekielek:

Dr. Joseph Varon, it’s such a pleasure to have you on the show.

Dr. Varon:

Thank you for having me.

This interview was partially edited for clarity and brevity.