Let’s Make a (Iran) Deal

 by James Rickards

Can a popular 1960s television game show help us understand Donald Trump’s decision-making process with regard to the war in Iran?

The answer is yes.

To understand why, we first need to understand how the game show worked. Using that as a model, we can apply it to Trump’s choices in Iran, see how he arrived at the current ceasefire and negotiation stage and consider what may come next.

The game show we’re considering was called Let’s Make a Deal. The host was Monty Hall, a Canadian-American talent who hosted the show from its debut in 1963 through 1976. The show was continued in many forms under different names all over the world, but the original format is what we want to study for geopolitical purposes.

The game consisted of a stage with three closed doors. Behind one door was a grand prize, such as an all-expenses-paid trip around the world. Behind another door was a modest prize, perhaps a TV set or kitchen appliance. The remaining door had a comedic “zonk” prize with little or no value. One of the famous zonk prizes was a live goat.

The number and order of the doors doesn’t matter mathematically, but for purposes of illustration, we can say that Door No. 1 has the grand prize, Door No. 2 has the zonk prize and Door No. 3 has the modest prize. The contestant does not know which door holds which prize.

The contestant was offered something of reasonable value but was allowed to “trade” that item for something hidden behind the doors. Most contestants would do the trade. Then they had to pick a door. Let’s say the contestant chooses Door No. 3.

Here’s where the game gets interesting.

Monty Hall, knowing where the prizes were, would walk up to the stage and open one of the doors the contestant did not choose. In our example, he would open Door No. 2 to reveal the zonk prize. He would then ask the contestant if she would like to change her mind. The contestant could switch from Door No. 3 to Door No. 1 or could stand pat with Door No. 3.

Most contestants would stick with Door No. 3. Their logic was that Door No. 3 originally had a one-third chance of being the grand prize. That’s the correct probability.

They would reason intuitively that Door No. 1 also had a one-third chance of being the grand prize. Since the odds were the same between Door No. 1 and Door No. 3 and since nothing had changed, there was no reason to switch doors.

If the contestant stuck with Door No. 3, that door would eventually be opened and the contestant might or might not win the grand prize.

The Math Most People Get Wrong

It’s counterintuitive, but the logic most contestants use is incorrect.

Door No. 3 still has a one-third chance of containing the grand prize. But Door No. 1 actually has a two-thirds chance.

A contestant given the situation described above should always switch doors. That doesn’t guarantee a win every time, but it does double the chances of winning.

Here’s why:

At the start of the game, Door No. 3 has a one-third chance of holding the grand prize. That means Doors No. 1 and No. 2 combined have a two-thirds chance.

The key insight is that Monty Hall is not opening a random door. He knows where the prizes are and deliberately reveals a losing door.

When Door No. 2 is opened and shown to contain the zonk prize, the two-thirds probability that originally belonged to Doors No. 1 and No. 2 does not disappear. Instead, it shifts entirely to Door No. 1.

Nothing has changed about Door No. 3. It still has a one-third chance of containing the grand prize.

But Door No. 1 now carries the full two-thirds probability that was previously shared between Doors No. 1 and No. 2.

That’s why switching doors improves your odds of winning.

This is a simple example of Bayes’ Theorem. You start with the best estimate you can make based on the information available. When new information arrives, you update your assessment.

Once Monty Hall reveals that Door No. 2 contains the zonk prize, the odds change. A rational contestant updates the probabilities and switches doors.

(By the way, when the Let’s Make a Deal solution was first published, thousands of readers — including many with PhDs — wrote in insisting there was no benefit to switching.

Experiments with pigeons showed the opposite. Pigeons almost always switch.)

Trump’s Three Doors

Interesting. But what does this have to do with Trump and the war in Iran?

It turns out that Trump has a Monty Hall problem of his own in terms of policy choices in the war.

The grand prize, from a practical standpoint, is a negotiated settlement. It doesn’t sound appealing, but it would end the fighting, reopen the Strait of Hormuz, help reunite MAGA and get Republicans focused on the midterm election.

The zonk prize is a continuation of the stalemate. This avoids fighting in the short run, but it keeps the Strait of Hormuz closed. The world was close to running out of energy and other strategic inputs, and major parts of the global industrial economy were coming close to shutting down. It was the worst possible outcome economically and politically.

The modest prize is escalation. It has a short-term feel-good aspect to it, but it doesn’t accomplish much in the long run without 600,000 boots on the ground. It might reopen the Strait of Hormuz, but at a high cost in lives and treasure.

We can think of retreat behind Door No. 1, stalemate behind Door No. 2 and escalation behind Door No. 3. Retreat has a political cost. Stalemate has an economic cost. Escalation has a cost measured in uncertainty and casualties.

The Zonk Prize Revealed

Trump was merely guessing as to which choice had the best outcome and which choice was the zonk prize.

Two weeks ago, Trump was leaning toward Door No. 3 without really knowing what he was doing or what the outcome might be. He was guessing.

At this point in the policy process, JD Vance and others explained to Trump that Door No. 2 was the zonk prize. In effect, he opened the door like Monty Hall.

Door No. 2 was never a good outcome. The result of running out of energy was always going to be catastrophic. It was just a matter of time and the time was near.

Now Trump was like the contestant in Let’s Make a Deal. He could stick to Door No. 3 or switch to Door No. 1.

His goal was to get the best possible outcome for the United States without really knowing how to achieve that. When he saw that stalemate was the zonk prize, the odds favored switching strategies to increase the odds of success.

And that’s what he did.

Why Trump Switched Strategies

Over the course of June 11 and 12, 2026, Trump first threatened to bomb Iran into reopening the Strait and then abruptly announced a planned memorandum of understanding (MOU) that would reopen the Strait by giving Iran most of what it was asking for and leaving critical issues to be negotiated over the next 60 days.

In effect, Trump switched from Door No. 3 to Door No. 1 to increase the chance of success.

It worked.

The odds of the Strait reopening went up significantly and, as of today, substantial tanker traffic is in fact moving through the Strait (although it’s a tenuous situation with Iran firing on an oil tanker in the Strait just yesterday). Economic catastrophe has been averted at the cost of some embarrassment for the United States.

But we still achieved the best possible outcome.

The Next Round of the Game

Of course, war and diplomacy are far more complex than Let’s Make a Deal. There are many mixed cases. Agreements like the MOU can be torn up and the war restarted.

Or the MOU negotiations can be used by both sides to restock depleted weapons systems in preparation for another round of fighting.

Trump has already said he will “bomb the hell out of” Iran if it doesn’t live up to his expectations under the MOU.

New doors and new choices keep emerging.

Still, models are a useful way to analyze complex problems when all the inputs are not known. Bayes Theorem, which is the model behind the Monty Hall problem, is a powerful tool that I used frequently in my work at CIA.

The lesson is straightforward: Start with the best assessment you can make. Then update that assessment when new information changes the odds.

Rather than throw up our hands at Trump’s apparent contradictions, we can view his decisions as responses to changing information and changing probabilities.

That approach won’t predict every outcome, but it can help us make more accurate forecasts than intuition alone.

https://dailyreckoning.com/lets-make-a-iran-deal/

SpaceX will join Nasdaq-100

 

• Nasdaq announced that Elon Musk’s SpaceX would join the Nasdaq-100 index.
• Assuming the company meets the exchange’s requirements, index-tracking funds — like the popular Invesco QQQ Trust (QQQ) — can start buying shares after the market closes on July 6.
• The aerospace and satellite company is expected to enter the tech-heavy index with a weighting of less than 1%.

• SpaceX became one of the quickest additions ever to the Nasdaq-100 index, setting up a fresh wave of buying from passive investors less than a month after the company’s blockbuster public debut.

  Nasdaq announced after the close Friday whether SpaceX qualifies for inclusion in the benchmark technology index. Assuming the company meets the requirements, index-tracking funds and other product sponsors would begin purchasing shares after the market closes on July 6, with SpaceX officially joining the Nasdaq-100 before trading begins on July 7.

  More than $800 billion tracks the index, including the Invesco QQQ Trust (QQQ), which is one of the most popular securities traded each day and is seen as a barometer for the artificial intelligence bull market.

  The aerospace and satellite company is expected to enter the index with a weighting of less than 1%.

  Adding SpaceX this quickly would make the Elon Musk company one of the first beneficiaries of Nasdaq’s recently adopted fast-track inclusion framework for newly public companies. The changes allow some large IPOs to become eligible for the Nasdaq-100 after just 15 trading days, dramatically shortening what had historically been a far longer waiting period.

  Under the previous framework, investors tracking the Nasdaq-100 could be forced to wait months before gaining exposure to newly listed market giants.

  The inclusion could create another source of demand for SpaceX, which has been one of the most actively traded stocks since its June 12 debut. Index funds and exchange-traded funds tied to the Nasdaq-100 would need to buy shares to match the benchmark’s new composition, while active managers who track the index closely might also adjust positions.

  Because SpaceX’s publicly tradable float remains small compared with its total market capitalization, even a modest index weighting could require meaningful purchases from passive investment vehicles.

  Earlier this month, S&P Dow Jones Indices declined to create a similar fast-track process for the S&P 500. Therefore, SpaceX remains ineligible for inclusion in the S&P 500 because of that index’s separate profitability and seasoning requirements.

• https://www.cnbc.com/2026/06/26/spacex-added-to-nasdaq-100-on-hold-on-hold-on-hold.html

Trump-Backed Colombian President-Elect Gives Guerrillas "1 Month To Surrender" As Socialist Era Ends

 Colombia's president-elect Abelardo de la Espriella gave drug cartels and guerrilla groups one month to surrender, marking a massive U-turn from the soft-on-crime policies of the socialist regime under incumbent President Gustavo Petro.

"To all those acting outside the law, you have one month to arrange your submission," Trump-Backed Espriella said in his first speech since official results confirmed his electoral win on Sunday.

"In my administration, there will be no generous offers or unacceptable concessions like those they received from the regime that is coming to an end," Espriella added, in reference to the outgoing socialists who favored kind words with narcoterrorists.

Under Petro, a new United Nations report showed that Colombian coca cultivation hit a record high in 2024, with planted acreage rising 3.5% to 261,000 hectares, or about 645,000 acres.

The UN Office on Drugs and Crime did not publish its usual estimate for potential cocaine output, although the previous year's coca crop was enough to produce more than 2,600 tons of the drug, according to Bloomberg.

The surge in production under the socialist regime has fueled Colombia's worsening security crisis.

Across Latin America, there has been a massive shift in politics after years of failed socialism sent the continent into an era marked by surging violent crime, economic stagnation, debt traps, currency declines, and collapsing public confidence.

Now, the shift is toward right-wing leaders who support law and order and capitalism.

As socialism and Marxism are eradicated like cockroaches across Latin America, a troubling rise of left-wing revolutionaries in New York City has finally alarmed the mainstream Democratic Party.

https://www.zerohedge.com/geopolitical/trump-backed-colombian-president-elect-gives-guerrillas-one-month-surrender-socialist

Medicare Advantage Company Elevance Pays $342M to Government Amid Billing Probe: KFF

 A major Medicare Advantage company has paid the government more than $342 million to help settle allegations that it overcharged the federal healthcare program for years.

Elevance Health, which covers about 2 million people on Medicare, sent the money to the Centers for Medicare & Medicaid Services (CMS) via wire transfer on May 27, court records show. Government lawyers disclosed the payment in a June 22 court filing.

In an email to CMS staff, Elevance described the money as a "remittance of the total overpayment amount" estimated by government audits, court records show. Company spokesperson Leslie Porras told KFF Health News in a statement that Elevance Health "continues to engage in constructive dialogue" with CMS. "We remain optimistic that a resolution can be reached and value our longstanding relationship with CMS," she said.

The payment was made in response to a CMS enforcement action in February, in which the agency threatened to halt enrollments in Elevance Medicare Advantage plans unless the company corrected what CMS called "substantial and persistent noncompliance" with federal regulations that require health plans to submit accurate billing data and return any overpayments when they are discovered.

It appears to be the first time CMS has successfully pressured a Medicare Advantage health plan to pay back tens of millions of dollars in alleged overpayments -- even though agency officials have known for years that many health plans have overbilled the program, according to audits by government staff.

"I've never heard of something like this before," said David Lipschutz, an attorney with the Center for Medicare Advocacy, a nonprofit public interest law firm. "Usually plans seem to tie everything up and try to delay any repayment of anything for years."

David Meyers, PhD, MPH, an associate professor at the Brown University School of Public Health in Providence, Rhode Island, called the payment "substantial" and "a step in the right direction" toward holding the industry accountable.

"It's a big win for CMS to get that much," he said.

More than 35 million Americans, about 55% of people on Medicare, have signed up for the private Advantage health insurance plans, which offer extra benefits, such as hearing aids and dental coverage, that traditional Medicare doesn't cover.

Joining the plans may also prove cheaper for patients than purchasing a supplemental insurance policy that covers gaps in traditional Medicare.

Whether Medicare Advantage is a good deal for taxpayers is hotly debated, however.

The health plans have been the target of dozens of whistleblower lawsuits and government investigations alleging they often exaggerate how sick patients are to improperly boost their payments, claims the industry disputes. Medicare pays health plans higher rates for sicker patients but requires that the plans bill only for conditions that are properly documented in a patient's medical records.

Researchers also have concluded that Medicare overpays the health plans by billions of dollars every year because of medical coding flaws that generate higher bills than are justified.

The whistleblower suits, mostly filed by former employees of healthcare companies, have long served as the primary tool for clawing back alleged overpayments. In January, Kaiser Permanente agreed to pay $556 million to settle Justice Department allegations that it billed the government for medical conditions patients didn't have, the largest such penalty to date. In a statement posted on its website, the company said it settled the case "to avoid the delay, uncertainty, and cost of prolonged litigation."

By contrast, CMS' efforts to prevent Medicare Advantage plans from overcharging have largely foundered.

In 2014, for instance, CMS backed off a proposed regulation that would have cracked down on overbilling amid an "uproar" of opposition from the industry. And even when CMS audits uncovered tens of millions of dollars in overpayments, agency officials collected only a tiny fraction of that amount.

The CMS threat to bar Elevance from enrolling new members may open a new approach.

"The payment Elevance is making here is not trivial," said Matthew Fiedler, PhD, a health policy researcher at the Brookings Institution.

But he noted that it represents a very small fraction of the total the company receives from Medicare. He said that making a big dent in the overpayment problem would require CMS to collect "many similar payments" -- from "every" Medicare Advantage insurer.

"I don't think there's a clear reason to believe that at this stage," Fiedler said.

Richard Kronick, PhD, a former federal health policy official and a professor at the University of California San Diego, agreed that the payment reflects a small portion of the company's revenue. But he said it was "still a sizable check to write."

Kronick said the action reflects "perhaps a bit of muscle flexing" by CMS to tighten up enforcement.

CMS did not immediately respond to a request for comment. It's not clear from court records whether the payment will end the CMS threat to ban Elevance from signing up new members.

If so, it might prove to be a relative bargain. In an April filing with the Securities and Exchange Commission, the company noted that its "current best estimate" of the "potential exposure" in the case was approximately $935 million.

Elevance has been at odds with the federal government over its billing practices since 2020, when the Justice Department filed a False Claims Act lawsuit against the company, then known as Anthem. That case is pending.

Court filings in that case disclosed the company's payment to CMS. In an email made part of the court file, a company official confirmed it had sent the wire transfer in the amount of $342,209,085.30 on May 27 and said the payment was related to the threatened enrollment ban. The company also stated that it was challenging the CMS enforcement action and called it "unprecedented."

In defending against the Justice Department suit, Elevance has denied wrongdoing and argued that CMS knew about its billing practices for years and took no action.

Meyers, the Brown University professor, said CMS' success in collecting payment from Elevance may encourage more enforcement.

"It remains to be seen whether this is a sea change," he said.

https://www.medpagetoday.com/publichealthpolicy/medicare/121947

I Watched My Friend Choose Death. Physician-Assisted Suicide Needs More Guardrails.

 "Have yourself a good life."

That was my friend's message informing me of his plan to end his life through physician-assisted suicide. His pancreatic cancer had progressed and was no longer responding to treatments. Weeks before, he shared he might soon enter hospice. He reflected upon his proudest lifetime accomplishment as my surgery scheduler: creating a new policy for clinic patients to expedite care.

The tumor soon caused a bowel obstruction requiring hospitalization. His surgeon said nothing more could be done. He planned to end his life before he could no longer be independent.

When I saw him in the hospital, he was upset to learn the costs for the morphine cocktail and physician to deliver the medications reached nearly $2,200. The social workers told him MediCal would only cover a hospice nurse, and he did not have the income to cover these extra expenses. He did not want his family or friends to be financially burdened.

Unfortunately, within days after discharge, he was readmitted with another obstruction. From his hospital bed, he resolved to end his life after returning home. Three of us were present at the end -- he was grateful not to be alone as it takes great courage to drink the cocktail. What do you say to someone in the last 30 minutes of life? We talk about firsts in life (first job, first love) but not lasts. The conversation was as carefree as any other. I thanked him for his friendship and excellent patient care, and wished him well on his journey.

He sat in his favorite chair listening to his favorite song as the time arrived. Within 4 minutes of consuming the cocktail, he lapsed into unconsciousness. I held his hand 15 minutes longer until I could no longer feel a pulse. His complexion darkened, and then came the ominous death rattle that we dread to hear in the hospital. He passed an hour later.

All in all, it was a 12-day emotional roller-coaster -- of being resolute, of fear of the unknown, of sadness, of concern for those left behind. In his final week, he reassured me that he was at peace with his decision, and spoke with a chaplain before death. Ultimately, his primary hope was there was something better in the afterlife compared to continued existence on this planet.

Sixteen days later, I chaired an American Medical Association (AMA) Committee regarding a request to rename physician-assisted suicide as "medical aid in dying." There was also a discussion of whether physicians and patients who participate in physician-assisted suicide should be shielded from criminal or civil penalties. The testimony was passionate and touched on broad aspects of physician-assisted suicide. Some opposed physician-assisted suicide for ethical and religious reasons, or viewed it as violating the Hippocratic Oath; someone even invoked Jack Kevorkian. They noted that assisting in a suicide is illegal in every state (with physician-assisted suicide being the exception in some states). Others praised the intent to alleviate suffering and restore patient autonomy.

As I listened to the debate, I wondered: how many had ever actually witnessed the final moments?

Soon after the final vote to reject the name change and to maintain a stance against physician-assisted suicide, the AMA's opposition was cited in a Wall Street Journal editorial against a New York bill to legalize physician-assisted suicide. The nation was watching and listening.

Thirteen states and Washington D.C. have legalized physician-assisted suicide, with Oregon enacting the first law in 1997; specific eligibility requirements vary by state. Data from 1998-2020 data show that 5,329 Americans have died using this method. By September, nearly a third of Americans will live in states with legal physician-assisted suicide. Another 16 states are considering legislation.

My friend gave me permission to share his story to make the system better. As I reflect on his experience, I would urge the strengthening of policy guardrails before expanding physician-assisted suicide to more states and more patients. First, we need to reduce the financial burden to spare others the exasperation my friend endured; a financial barrier to accessing this final treatment seems unfair.

Second, it is difficult for family and friends to witness a death by suicide, which is not a normal or natural death. Perhaps they should not be present, or be better prepared for the events to come. As a surgeon, I have seen death firsthand, but usually in intubated patients, not those you are chatting with minutes before. Some soldiers have had a similar experience, speaking to a comrade moments before they are killed in battle. This can be uniquely devastating.

Third, some patients never actually take the cocktail after it's delivered to them. Ensuring safe storage and disposal of unused medications is essential.

Fundamentally, the question remains whether physicians should be involved at all. Perhaps one option is to end physician involvement after certifying that a patient qualifies, and delegate the remaining steps to others like a pharmacist or the coroner.

Physicians should instead focus on supporting terminal patients and finding new cures to push the limits of medical knowledge. A leading reason for physician-assisted suicide requests is Lou Gehrig's disease. But imagine if Stephen Hawking had pursued this option: instead of going on to accomplish all he did, he may have ended his life at 21. In 2028, we will celebrate the 100-year anniversary of the discovery of penicillin, which cured many bacterial infections often considered fatal. Someday medical breakthroughs may cure cancers just as readily, and some will look back and wonder why we focused on ending lives instead of bringing new treatments into reality sooner.

John Maa, MD, is a surgeon and the American Medical Association (AMA) Delegate for San Francisco.

https://www.medpagetoday.com/opinion/second-opinions/121941

Houston drowning tests if Texas law gives right to deny brain death testing

 Parents of a 2-year-old girl involved in a drowning incident on Memorial Day have sued to stop Texas Children’s Hospital from testing if she’s brain dead, testing a new strategy in Texas’ “right to life” movement aimed at giving people as much access to life-supporting services as possible.

While most fights to keep patients on life support begin after they’ve been given a brain death diagnosis, Annelise Camp’s parents are battling the hospital at an earlier stage, the testing phase. 

“This is not settled science,” said state Rep. Steve Toth, R-The Woodlands, who has helped drive the public’s attention to the Camps, who live in Cypress.

Brain death is defined in Texas law as the irreversible cessation of brain function. Under the law, once a patient is declared brain dead, a hospital can withdraw life-sustaining measures. 

According to court documents, the Camps say Annelise shouldn’t be tested for brain death so she can have more time to recover. They also ask that she be transferred to another hospital to explore other treatment options. However, Texas Children’s has stated it wants to conduct testing to determine next steps in her medical care and that it has no imminent plans to end care for Annelise. 

This case has drawn the attention of Texas Attorney General Ken Paxton, who posted on X in support of the Camp family: “I am closely monitoring this case and will act to protect this child and honor her parents’ efforts to save her.” Influential anti-abortion group Texas Right to Life has started working with the family, too.

Given growing attention to the Camp family’s fight, bioethics and legal experts say that this could empower other families to fight brain testing, which is becoming more common. The case has already inspired at least one lawmaker to create new laws and build on Texas’ existing laws that protect the rights of patients and their families to extend life-sustaining services and access experimental treatments. 

The lawsuit is the latest chapter in a yearslong fight among some right-to-life advocates to end the brain death diagnosis because they believe multiple organs have to fail to be considered a biological death. 

Meanwhile, medical experts believe there needs to be a “clear line” that distinguishes life from death otherwise ICUs would lose capacity to treat patients that have a chance of recovery, said David Magnus, a Stanford University medicine and biomedical ethics professor.

It appears no courts in Texas have determined the legality of brain death tests, said Thomas Mayo, professor emeritus of law at Southern Methodist University. If the state district court rules in the family’s favor, it would not be binding in other courts, Mayo said. 

However, “if Texas Right to Life is involved in any way, and the family loses, this case would likely go to appeal,” he added. 

The brain death debate

The Camp family were visiting relatives on Memorial Day, when Annelise wandered into the hotel pool without her life jacket, Johnston Camp, Annelise’s father, told FOX 26 Houston in early June. She was pulled out of the water by family members who began CPR until first responders arrived. Camp was taken to Texas Children’s west Houston location and after an hour her heartbeat returned.

“She never gave up when I asked her to do something… I’m never gonna give up on her,” Camp told the station. 

Since the interview, the Camps have declined speaking to The Texas Tribune, citing a court order that prevents them from doing so, said their lawyer Heath Novosad. Texas Children’s has also declined to comment on the case. 

Three days after Annelise was hospitalized, her parents filed a temporary restraining order against Texas Children’s after physicians said they had exhausted all treatment options and advised that the child get tested for brain death, according to court documents filed in late May. The documents say Annelise’s heart was beating, although she was dependent on a ventilator. The Camps have refused any brain death testing and want to transfer Annelise to another hospital to receive hyperbaric oxygen treatment or stem cell therapies. 

Texas Children’s officials said in court documents they’ve contacted medical facilities to ask about accepting Annelise, but 35 of the 36 have declined and the one pending hospital said it needed her to undergo brain death testing to consider transfer.

The court granted the family’s request for a temporary injunction and the family is asking for a permanent halt to brain testing. 

Hospitals usually notify family members, but are not required to get permission from them or the patient to conduct brain death testing. 

Under the Uniform Determination of Death Act, if someone is determined brain dead, they are considered legally dead and hospitals have the right to discontinue organ-supporting services. 

According to Texas Right to Life, which has long fought the legal recognition of brain death and its use to stop life-sustaining measures, brain death is not consistent with the Christian faith. As long as there is a heartbeat, a person is still alive. The Camp family has stated in court documents brain death testing is against their religious beliefs.

“Texans have the right to say we don’t believe in this,” said John Seago, president of Texas Right to Life, adding that his organization has worked with 106 patients to fight for life-sustaining treatment, an increase in the last three years. “A dead person has no rights, and that’s the problem with the brain death concept, in general, is it is a shortcut to deprive individuals of the right to life and other rights.”

Magnus, the Stanford professor, said that if hospitals are no longer able to diagnose someone with brain death and are forced to keep more people on life support, this could strain resources, such as ICU beds.

“Using that scarce resource for somebody who has no chance of ever making any recovery doesn’t really make a lot of sense,” he said. “When the hospital beds are full, Texas will not be a good place to get sick.” 

Magnus worries that if hospitals are no longer allowed to recognize brian death diagnosis, organ procurement could decline which places the burden of organ donations on other states or else, many Texans could be at risk of dying.

“That means that if you have renal failure, you die. You have liver failure in Texas, you’ll die. When you have heart failure in Texas, you’ll die,” he said. 

While some of the loudest critics of the brain death diagnosis have been among anti-abortion advocates, not all are in agreement. Texas Alliance for Life points out that the definition of death in state law is based in “sound medical science,” its executive director Amy O’Donnell said. She declined to comment specifically on Camp’s case.

Room to expand “right to life” laws?

In the last few decades, Texas legislators made attempts to create and fine-tune “right to life” laws that expand the rights of those who have been declared brain dead. None have addressed brain death testing, which is ripe ground for new legislation.

“We passed legislation in the state of Texas and we think people will just follow it,” Toth said. 

In 2023, state lawmakers expanded the Right to Try law – originally limited to terminally ill patients – to give chronically ill patients access to investigational treatments if they had exhausted approved options. The same year, the Legislature changed the Texas Advance Directive Act, so that hospitals must give families of patients 25 days’ notice before pulling life support, increasing it from 10 days. Although, groups like Texas Right to Life believe that there should be no time limit.

This change came three years after the family of 1-year-old Tinslee Lewis challenged the advance directive act, also garnering national attention. Lewis was born with a rare heart defect that kept her on life-support in Cook Children’s Medical Center’s ICU from birth. Leveraging the law’s life-support time limit, doctors at the Fort Worth hospital wanted to take Tinslee off life support against her mother’s wishes and an appeals court ruled in the family’s favor. Lewis was discharged after two years, according to CBS.

Toth, who carried the House version of the bill that changed the Right to Try law in 2023, said he would push to give families the right to contest the brain death test and make it difficult for hospitals to procure organs from patients declared brain dead.

Toth, who won the Republican primary for Texas’ 2nd Congressional District in Houston in the spring, ultimately wants to eliminate the brain death diagnosis on a national level. 

“I think that we’ve got to be really careful at just observing the rights of parents to make this decision, this call for themselves,” said Toth. 

Texas does not have legislation that provides for a reasonable accommodation of a religious objection to brain death, said Mayo.

If the brain death diagnosis was taken off the books, hospitals can still leverage the Texas Advance Directive Act which places a time limit on how long a hospital is responsible for life-supporting treatment, Magnus said, but “courts in Texas have been inconsistent about applying their own law.”

“Courts in other states have gone back and forth over whether a determination of brain death can be done at all, and whether once it’s done, the physician’s findings are determinative of further treatment or stopping treatment. I think it’s a very, very emerging question that is getting disparate treatment in various jurisdictions,” said Mayo.

In these cases, the courts will usually tell the hospital to keep the patient on life support, said Magnus. “Basically the courts don’t want to be the one that makes [the brain death] determination,” he said.

Disclosure: Southern Methodist University and Texas Children’s Hospital have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

https://www.texastribune.org/2026/06/22/texas-childrens-hospital-brain-death-testing-annelise-camp/