Organ Donation Gone Wrong: What Every Honolulu Family Needs to Know

When most people in Honolulu think of estate planning, they picture wills, trusts, and deciding “who gets what.” But what happens when you can’t speak for yourself, and life-or-death decisions have to be made?

A recent federal investigation revealed a chilling reality: in dozens of cases, patients showed signs of consciousness as hospitals prepared to remove their organs for donation. This isn’t a distant, unlikely scenario—it’s happened to real families, with real consequences. Without proper planning, your loved ones might be asked to make heartbreaking decisions with little guidance from you.

In this article, I’ll walk you through how comprehensive Life & Legacy Planning protects not only your loved ones, but you. We’ll discuss what happens in Hawai‘i hospitals when there’s no clear plan, how to make your medical wishes known, and how to make sure no one makes those decisions for you without your voice.

When Organ Donation Goes Wrong

According to a 2025 New York Times report, Anthony Thomas Hoover II’s family made the agonizing decision to withdraw life support and donate his organs after a drug overdose left him near death. As doctors began preparing for the procedure, he woke up.

Hoover cried, curled into a ball, and visibly protested. A physician intervened just in time. Hoover survived, but with serious neurological injuries.

This isn’t an isolated incident. A federal review of over 350 cases flagged 73 where patients showed signs of life during organ donation prep. Some recovered. Others died without ever having their true wishes known.

The common denominator? A lack of clear, legally documented decisions from the patients themselves.

What Happens in a Hawai‘i Hospital Without a Plan?

If you become unable to speak for yourself and don’t have a healthcare directive in place, medical staff must rely on whatever information is available, if any.

Here’s how decisions are usually made:

• They check your driver’s license for organ donor status.

• They look for any advance directives on file.

• If nothing is found, they default to Hawai‘i’s legal hierarchy to choose a decision-maker (usually a spouse, adult child, parent, or sibling).

But what if you're estranged from your spouse? What if your adult children disagree? Or worse — what if the person legally authorized to decide doesn’t really understand what you'd want?

In an emergency, time is short. Doctors need quick answers. And your family may feel pressured to make decisions without the clarity they need.

How to Ensure Your Voice Is Heard

A truly effective Life & Legacy Plan includes specific documents that protect you and guide your loved ones during a crisis. These include:

✅ Living Will (Advance Health Care Directive)

Outlines your preferences for life-sustaining measures like resuscitation, ventilation, and artificial nutrition. It answers key questions: Under what conditions would you want care withdrawn? When should treatment continue?

✅ Durable Power of Attorney for Health Care (Advance Health Care Directive)

Names the person you trust to make medical decisions if you're unable to. In Hawai‘i, this is critical — without it, your care may fall into the hands of someone you wouldn't choose.

✅ HIPAA Authorization

Gives your decision-makers the right to access your private medical information. Without it, even close family may be shut out from vital updates.

✅ Organ Donation Instructions

Instead of just checking a box on your license, I help clients in Honolulu document detailed preferences about organ donation, ensuring your values are clearly spelled out and honored.

Why Documents Aren’t Enough

It’s not enough to just sign these papers and file them away.

Your documents:

• Need to be current.

• Must be easily accessible in an emergency.

• Should be understood by your loved ones.

And perhaps most importantly, your family needs to know why you made the choices you did. A conversation is just as essential as any legal document.

When you explain your decisions — why you would or wouldn’t want to remain on life support, or why you’d want to donate organs in specific situations — you lift a tremendous emotional burden. Your loved ones won’t be stuck second-guessing themselves. They’ll know they’re honoring your wishes.

A Trusted Guide in a Time of Crisis

When you create a Life & Legacy Plan with me, I don’t just hand you a binder and send you on your way. I stay with you and your ʻohana for the long term.

In a medical emergency — or after your passing — your family will have someone to turn to. Not a hospital administrator. Not a court. But a real human being who knows you, your values, and your wishes.

FAQs

I already checked “organ donor” on my license. Isn’t that enough?

Not always. Hospitals and organ procurement agencies may act quickly, and your family might not fully understand your preferences. A detailed directive ensures your wishes are respected.

Can’t my spouse or kids just decide for me?

Maybe. But not always. And what if they disagree — or don’t know what you’d want? Legally naming someone and giving them clear instructions protects everyone involved.

I signed a directive years ago. Is it still valid?

Possibly, but it may be outdated or no longer reflect your wishes. It’s smart to review these documents every few years or after major life changes.

Ready to Protect Your Wishes?

If the thought of being treated as an organ donor before you're truly gone sends chills down your spine, you’re not alone. But this is preventable.

With a Life & Legacy Plan tailored for Hawai‘i families, you can protect your voice, ease your family’s burden, and ensure your values are honored when it matters most.

Reach out today to schedule a planning session. Let’s make sure no one has to make heartbreaking decisions for you without knowing exactly what you’d want.

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This article is brought to you by the Law Office of Keoni Souza, a boutique estate planning firm located in Honolulu, Hawaiʻi, proudly serving families on Oʻahu and across the Hawaiian Islands. At our firm, estate planning is about more than documents—it’s about creating lasting peace of mind for you and the people you love. Through our unique Life & Legacy Planning Process, we guide you to make informed, empowered decisions that protect your wealth, your wishes, and your family’s future. To get started, contact our Honolulu office today to schedule your Family Wealth Planning Session. Mention this article to learn how you can receive this $750 session at no charge.

Disclaimer: The information on this website is for informational purposes only and should not be considered legal advice. For guidance tailored to your specific situation, please consult an estate planning attorney licensed in the State of Hawaiʻi. Use of this website or communication through this site does not create an attorney-client relationship with the Law Office of Keoni Souza, LLC.