Article posted with permission from the author, Kate Shemirani

They are not your loved one’s nurse. They do not work for you. Yet there they are, standing silently in the shadows of intensive care, watching, waiting, building rapport. They are the SNODs – Specialist Nurses in Organ Donation. You were never told they were embedded. You didn’t consent to being approached. You didn’t know your loved one had been flagged. But make no mistake: they were.

1.🩸 What Is a SNOD?

SNOD stands for Specialist Nurse in Organ Donation. These individuals are deployed in UK hospitals to facilitate organ harvesting from patients declared dead – often under the contested definition of ‘brainstem death.’ Introduced formally after the Organ Donation Taskforce in the mid-2000s, SNODs now work closely with transplant teams and ICU departments. They do not declare death, but they do appear quickly after it – sometimes before.

2.🔍 Embedded… Or Undercover?

NHS documents describe SNODs as ‘embedded’ in hospital settings. But what does that really mean? It means they are present inside ICU units, **monitoring** patients who may soon be eligible for donation. It means they often approach families when their guard is down, offering ‘support’ while steering the conversation toward consent.

Embedded, in this context, is a sanitised way of saying **in place, with a purpose not clearly disclosed to the patient or family**. This is not holistic care. It’s strategic influence, veiled in kindness.

3.⚖️ Ethical Concerns: The Illusion of Choice

Families are approached under immense emotional stress. SNODs are trained to ‘support’ them, but with a focus on obtaining consent – or presumed consent – for organ donation. Under the UK’s opt-out system, this becomes even more problematic.

Do families know who the SNOD really works for?
Do they know that donation pathways may begin **before** true death is confirmed?
Do they know that SNODs help coordinate organ retrieval surgery the moment life support is withdrawn?

This is not neutrality. This is **tactical positioning**.

4.💀 Who Do They Really Work For?

SNODs are employed by NHS Blood and Transplant (NHSBT), not by the hospital caring for the patient. Their role is aligned with **organ procurement targets**, not family preservation or patient advocacy. They are trained to approach grief-stricken families with empathy – but also persuasion.

And when organs are retrieved, the SNOD moves on to the next case. The grieving family is left behind, never truly understanding what just happened.

5.🔚 Conclusion: The Secret Nurse of Death

The presence of SNODs in critical care settings under the guise of nursing support is a betrayal of transparency. They are not neutral. They are not advocates. They are **agents of the transplant system**.

In a time of immense vulnerability, families deserve the truth. They deserve clarity, not coercion. The SNOD model may serve the transplant industry, but it does not serve ethics, dignity, or the sanctity of death.

And so, we must ask: Is your loved one being cared for – or harvested?

Article posted with permission from Kate Shemirani