Ethical Analysis of Organ Recovery Denials by Medical Examiners, Coroners, and Justices of the Peace

Shafer, Teresa J.; Schkade, Lawrence L.; Siminoff, Laura A.; Mahoney, Timothy A.

doi:10.1177/090591999900900407

Cited by 3 publications

(2 citation statements)

References 143 publications

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“…Nonaccidental trauma that has resulted in the death of a child requires close cooperation between forensic investigators, treating physicians, the transplant team, and OPO to allow for successful organ recovery (209)(210)(211)(212)(213)(214)(215). However, despite encouragement from medical examiners, denials for organ donation continue to occur (216).…”

Section: Does Referral Of a Pediatric Victim Of Nonaccidental Trauma mentioning

confidence: 97%

Management of the Potential Organ Donor in the ICU

Kotloff

Blosser

Fulda

et al. 2015

Critical Care Medicine

272

150

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This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, authorization process, general contraindications to donation, hemodynamic management, endocrine dysfunction and hormone replacement therapy, pediatric donor management, cardiac donation, lung donation, liver donation, kidney donation, small bowel donation, and pancreas donation. Subcommittees were charged with generating a series of management-related questions related to their topic. For each question, subcommittees provided a summary of relevant literature and specific recommendations. The specific recommendations were approved by all members of the task force and then assembled into a complete document. Because the available literature was overwhelmingly comprised of observational studies and case series, representing low-quality evidence, a decision was made that the document would assume the form of a consensus statement rather than a formally graded guideline. The goal of this document is to provide critical care practitioners with essential information and practical recommendations related to management of the potential organ donor, based on the available literature and expert consensus.

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Section: Does Referral Of a Pediatric Victim Of Nonaccidental Trauma mentioning

confidence: 97%

Management of the Potential Organ Donor in the ICU

Kotloff

Blosser

Fulda

et al. 2015

Critical Care Medicine

272

150

View full text Add to dashboard Cite

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“…In some cases, the parents are suspected as the abusers, and they are also the people from whom consent for organ retrieval is sought. [1][2][3][4][5][6] A number of issues arise. Will organ donation interfere with an ongoing forensic investigation?…”

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confidence: 99%

For Victims of Fatal Child Abuse, Who Has the Right to Consent to Organ Donation?

Deutsch

Teeple²,

Dickerman³

et al. 2020

Pediatrics

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In rare circumstances, children who have suffered traumatic brain injury from child abuse are declared dead by neurologic criteria and are eligible to donate organs. When the parents are the suspected abusers, there can be confusion about who has the legal right to authorize organ donation. Furthermore, organ donation may interfere with the collection of forensic evidence that is necessary to evaluate the abuse. Under those circumstances, particularly in the context of a child homicide investigation, the goals of organ donation and collection and preservation of critical forensic evidence may seem mutually exclusive. In this Ethics Rounds, we discuss such a case and suggest ways to resolve the apparent conflicts between the desire to procure organs for donation and the need to thoroughly evaluate the evidence of abuse.

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Preservation of Evidence during Pediatric Organ Donation: A Modified Thoracotomy Procedure Designed to Increase Consent in Medical Examiner Cases

2011

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Deceased potential organ donors are often under the jurisdiction of medical examiners/ coroners. In these deaths, the medical examiner/coroner has the statutory responsibility of determining cause and manner of death but is also responsible for presenting findings from the complete autopsy in court. The ability to analyze findings such as location, nature, and age of rib fractures and patterned skin injuries may be crucially important to legal disposition, even though those findings may not be critical to determination of cause and/or manner of death. Potential alteration or destruction of those findings is one reason why a medical examiner/coroner may deny organ donation. We present here a modified surgical approach to accessing thoracic organs in children so that posterior rib fractures, which have particular significance in child abuse cases, can be preserved unaltered for subsequent autopsy. This simple modification of surgical technique has greatly facilitated the mutual goals of the medical examiner and the designated organ procurement organization in our jurisdiction, and it has thus decreased the frequency of denials of organ donation.

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Ethical Analysis of Organ Recovery Denials by Medical Examiners, Coroners, and Justices of the Peace

Cited by 3 publications

References 143 publications

Management of the Potential Organ Donor in the ICU

Management of the Potential Organ Donor in the ICU

For Victims of Fatal Child Abuse, Who Has the Right to Consent to Organ Donation?

Preservation of Evidence during Pediatric Organ Donation: A Modified Thoracotomy Procedure Designed to Increase Consent in Medical Examiner Cases

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