Organ Procurement and the Donor Family

Deal Breakers in the Organ Donation Request Process

“…However, even when a loved one's wishes are known, the decision is not always clear cut. Family members' personal reservations about organ donation often override their knowledge that the loved one intended to be an organ donor (Bogan et al 2000;Nathan et al 2003;Radecki & Jaccard 1997). While organ donation requestors might assume that families will automatically honor the directives of their loved one, hospitals are reluctant to press for organ procurement when the immediate family refuses to give its permission, regardless of whether a donor card or living will offers documentation to the contrary.…”

“…While there may be some minor variations from hospital to hospital, those reporting greatest success in increasing donation consent rates employ the core principles of this model. From the moment a patient is determined to be at high risk of dying, a designated family communication coordinator (FCC) should be assigned, and an organ procurement coordinator (OPC) from the Organ Procurement Organization (OPO) should be contacted (Bogan et al 2000;Exley et al 2002;Linyear & Tartaglia 1999). The responsibilities of this team are to enhance quality of care by advocating and providing support for the family, to ensure clear and consistent communication between the family and staff, to identify and meet practical and emotional needs during this difficult time, and to oversee consistent implementation of patient care and organ request protocols (Radecki & Jaccard 1997;Morgan & Miller 2001).…”

“…It must be decoupled 26 HEALTH MARKETING QUARTERLY from the family being told that the patient has no chance of recovery even if the body continues to function via life support systems (Bogan et al 2000;Cleiren & Van Zoelen 2002;Exley et al 2002). The family may not fully understand brain death, and need more clear and understandable information.…”

“…In fact, it is estimated that one-third of families desire more information on brain death, but do not have the courage or take the initiative to ask for it (Franz et al 1997;Rocheleau 2001;Sque et al 2004). This information should be provided multiple times through multiple modes as a grieving family is cognitively impaired and understands only 5-10% of the information initially provided (Bogan et al 2000). The most effective means of delivering the information is through written tools and visual aids.…”

“…As the waiting list grows, 6,000 potential donors are lost each year (Healthcare at the Crossroads 2004), and 18 waiting recipients die each day (UNOS.org 2006). Only 12-20% of potential donors become actual donors each year (Bogan et al 2000).…”