Organ transplantation and procurement is an ethically thorny issue as the involvement of the organ procurement agencies increases. There are approximately 112,000 people on the organ transplant waiting list. As a result UNOS (United Network for Organ Sharing) is ever increasing its reach to increase the recovery of organs and the condition of the organs procured. Currently ICUs are being encouraged to utilize organ preservation protocols in anticipation of the patient will becoming an organ donor. For example, in the ICUs, after a devastating stroke or traumatic brain injury, medications, lines, and procedures are being done on these patients before they are declared dead or determined to be a candidate for organ donation. The goal of these protocols is to improve the quality of the organs procured, should the patient progress to brain death or become a DCD (donation after circulatory death) donor. These protocols are implemented during the evaluation period of the patient for organ donation (in other words, some of these patients who receive organ preservation will not actually be a candidate for donation). The patients pay for all of these interventions if they are ultimately determined to not be a donor candidate. These protocols offer no benefit to the medical care of the patient and are not required for their treatment. The ethical issue is one of benefit and a utilitarian argument. UNOS argues the patient wants to donate (by checking the box on their driver’s license) and donation is “good” for society, therefore it is permissible to do things to patients that are not for their benefit medically. As donation after brain death occurs without consent of the family (only requires the checking of a box on the driver’s license) there is no discussion with the family regarding these protocols. Nor are families informed the cost of these interventions and given a choice regarding their utilization. This discussion will review the protocols, the creep of UNOS into the ICUs and before the patient is declared dead, and the ethics of medical interventions to a patient that is not for their benefit.