Evaluating a Successful Coroner Protocol

Jaynes, Christopher L.; Springer, James W.

doi:10.1177/090591999600600108

Cited by 3 publications

(4 citation statements)

References 2 publications

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“…In countries that have amended their legislation in line with the achievement of procurements, despite forensic deaths, the number of refusals decreased drastically. 14 –16 However, these legislative amendments require establishing protocols between forensic pathologists, transplant coordination teams, and prosecutors for optimal functioning. These protocols come in different forms: general protocol form to be completed by transplant coordination teams 14,17 ; organ-by-organ protocols 18 ; and specific protocols concerning precise situations.…”

Section: Discussionmentioning

confidence: 99%

“…14 –16 However, these legislative amendments require establishing protocols between forensic pathologists, transplant coordination teams, and prosecutors for optimal functioning. These protocols come in different forms: general protocol form to be completed by transplant coordination teams 14,17 ; organ-by-organ protocols 18 ; and specific protocols concerning precise situations. 19 The international literature has fully exposed this problem: Compliance with the conditions laid down by the regulations and protocols allows to exclude potential bias.…”

Section: Discussionmentioning

confidence: 99%

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Organ Procurement in Forensic Deaths

Delannoy

Jousset

Averland³

et al. 2016

Prog Transpl

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The need for organs has increased in the recent years, and this shortage will only worsen. In addition to the organs procured from brain-dead donors, a procedure for non-heart-beating donors was therefore developed. When deaths involve legal proceedings, the medical examiner makes the decision of whether or not to remove organs. To assist medical examiner in their decision-making, a number of forensic scientific societies aimed to develop recommendations, and legal adjustments were adopted. Nevertheless, these do present certain limits in special cases of procurement: Maastricht class I and II non-heart-beating donors. The peculiarity of this procedure stems from the urgency of the process. Compliance with temporal criteria would require that the deceased subject be removed from the crime scene even before the arrival of the authorities. This is extremely problematic legally and technically because forensic teams must collect evidence at crime scenes. Developments will have to be made to further minimize the restrictions on donations in forensic deaths.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Organ Procurement in Forensic Deaths

Delannoy

Jousset

Averland³

et al. 2016

Prog Transpl

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“…While proposed solutions by others have been numerous (see Table 3) and include (always first, foremost, and most obviously) cooperation and good communication, [166][167][168]179,185,186,[191][192][193] they do not go far enough. The need for good communication is self evident, but bears repeating, as the duties of both the OPO and the ME/C/JP are so important to the public good.…”

Section: Generate Potential Courses Of Action and Consider The Conseqmentioning

confidence: 99%

“…As concluded by others (N. Peerwani, MD, written communication, March 11, 1997), 164,165,168,237 the goals of organ donation and the collection of forensic evidence are not mutually exclusive. Medical exam-Improved communication: early and ongoing communication with the medical examiner regarding all aspects of each individual case Thorough evaluation and documentation; better documentation; delineation of tests, documentation, and consultations desired by medical examiner Development of policies and protocols regarding organ placement organizations and medical examiner/coroner interaction in potential donor cases Early notification of organ placement organization by hospital staff about potential lethal head injury Presence of the medical examiner or assistant medical examiner at time of surgical procurement Procurement team's commitment to availability for legal proceedings Formal retrospective review of all potential organ donors with the medical examiner Sharing of transplantation data, including the disposition of recovered organs, with the medical examiner Sharing of donor and recipient family responses to the procurement process with the medical examiner Education of medical examiner/coroner and organ procurement organization staff regarding organ donation and death investigation Legislation that prevents denials of organ recovery or that severely restricts conditions under which denials can occur Media attention to medical examiner/coroner denials Child abuse expert consulted on the case and/or notification of social services Table 3 Proposed solutions to decrease medical examiner/coroner denials and increase organ recovery [166][167][168][184][185][186][191][192][193] Ethical analysis of organ recovery denials iners and coroners could significantly increase organ recovery in the United States, if cases falling under their jurisdiction were routinely released for organ recovery and transplantation after appropriate examination. Ethical theory is a vital contributor to many disciplines, including medicine, nursing, public health, law, and the social sciences.…”

Section: Generate Potential Courses Of Action and Consider The Conseqmentioning

confidence: 99%

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

Shafer

Schkade

Siminoff

et al. 1999

Journal of Transplant Coordination

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Context Despite its pivotal nature, until the early 1990s the role of medical examiners, coroners, and justices of the peace was largely ignored in discussions of the critical shortage of organs for transplantation in the United States. These officials have the right to determine, from a medico-legal perspective, whether a deceased person can be an organ donor. Thus, they play an important role in the donation process. Using a principles-based ethical framework, this article examines the problem of nonrecovery of life-saving organs for transplantation in the United States because a medical examiner or other official denies recovery. Objective The goals of organ donation and the collection of forensic evidence are not mutually exclusive. An analysis of the ethical principles and obligations of beneficence, respect for autonomy, and justice reveals that medical examiners and other officials could probably, after appropriate review, release all cases under their jurisdiction for organ donation. Conclusion Medical examiners, coroners, and justices of the peace could assume a leadership role, working together on public policy with medical, social, and legal groups, spearheading efforts to stop the loss of organs due to official denials, up to and including state and federal regulation and legislation. Beyond their professional obligations, as agents of a social institution, medical examiners and other officials have the more general ethical responsibility of promoting the public health and welfare and of reinforcing societal consensus that transplantation is a social good which should be optimized through formal and informal activities.

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The Intersection of Death Investigation and Organ Donation Systems: A Scoping Review

Cullip¹,

Sarti²,

Weiss³

et al. 2022

Academic Forensic Pathology

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Introduction: Death investigators (DIs) such as coroners, medical examiners, and forensic pathologists play important and evolving roles in deceased organ donation. DIs communicate with organ donation organizations (ODOs) to gather case-specific information and release or restrict organs depending on the medicolegal requirements. This scoping review aims to identify the breadth of roles and decision-making processes that may facilitate or hinder deceased donation in DI cases. Methods: This study was conducted using a scoping literature review and subsequent thematic analysis. Results: Thirty-one eligible papers described 8 common themes with region-specific nuances. These include: 1) shared (ODO and DI) protocols for early communication around each case; 2) shared standards and education for death investigation practices related to organ donation; 3) DI support staff or teams to facilitate organ donation; 4) DI authority to order additional testing and imaging before organ recovery; 5) donation-specific legislation to enhance DI and/or ODO operations; 6) legally trained DI authority to veto medical decisions to proceed with organ donation; 7) DI attendance at organ recovery; and 8) surgeons recording specific DI evidence during organ recovery. Conclusion: These findings have cultural and resource-allocation implications and expose gaps in the international literature describing practices at the intersection of deceased organ donation and death investigation. A better understanding of the rationale and execution of various systems for DI and ODO cooperation may serve to advance both organ donation and death investigation.

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Evaluating a Successful Coroner Protocol

Cited by 3 publications

References 2 publications

Organ Procurement in Forensic Deaths

Organ Procurement in Forensic Deaths

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

The Intersection of Death Investigation and Organ Donation Systems: A Scoping Review

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