Can hospitals remove unvaccinated patients from organ donation lists?

Recently, patient D.J. Ferguson was removed from the heart transplant list by a hospital in Boston because the 31-year-old is not vaccinated against COVID-19. In Het Nederlands Dagblad, André den Exter, Associate Professor of Health Law at Erasmus School of Law, states that this case does not show discrimination: "This has nothing to do with being an anti-vaxxer".

The 31-year-old D.J. Ferguson suffers from genetic heart disease with potentially deadly consequences. He was placed high on the heart transplant list due to his young age and his two young children. However, the Brigham and Women's Hospital in Boston decided to remove the man from the transplant waiting list. Ferguson deliberately chose not to get vaccinated against COVID-19 whilst having enough time to do so. The hospital claims that this choice results in too big a risk of getting infected with the coronavirus and the occurrence of associated consequences.

Life or death

Worldwide, hospitals have been dealing with a shortage of donor organs for years. And this is not without consequences. "In case of a shortage of available donor organs, hospitals and transplant teams have to decide who gets them and who is not eligible to receive them", André den Exter explains. "The choice is one of life and death".


Heart patients are only eligible for a donor heart under particular circumstances. The heart disease must be end-stage, a patient must suffer from severe symptoms, transplantation must be the only possible solution that can lead to improvement, and there cannot be any contraindications. Den Exter states, "Contraindications are grounds on which a heart transplant does not have the desired effect". In the case of the unvaccinated Ferguson, there is a contraindication. "Because of the essential medication that suppresses the rejection of a donor heart, the immune system of a patient decreases". The decreased immune system results in a higher risk of infection, and therefore also of a COVID infection. Infection can cause rejection of a donor heart and even the premature death of a patient.

"This way, the decision about non-vaccinated heart patients is justified based on medical grounds", André den Exter concludes. And Ferguson? He has received a heart pump on January 25th 2022. This way, he hopes to continue his fight without giving up on his ideals.

Associate professor
More information

Read the whole article in Het Nederlands Dagblad here (in Dutch).

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