Organ Procurement in Forensic Deaths

Abstract

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.

Organ procurement in forensic deaths: French developments

“…Traumatised bodies that could constitute evidence are not taken because they have no therapeutic value. Our study also showed, as have many works published in the literature, [17][18][19][20][21] that if strict rules are observed and if a pathologist can examine the donor's body, there should be little or no doubt about any forensic conclusions: of the 27 autopsies performed after organ procurement that were analysed in this study 15 (eight criminal, eight suicidal, nine accidental, two medical malpractice), none showed interpretation bias related to surgical procedures, if procedural and scientific rigour in this process was followed to ensure judges the preservation of evidence.…”

“…In a previous study conducted at our institution between 2003 and 2011, 15 we noted that the main reasons given by judges for opposing organ removal in legal situations were lack of information on the circumstances of death (17%), the criminal nature of the death (28%) and, most importantly, the need for an autopsy (38%). This last and most-often expressed reason for opposition to judicial organ harvesting suggests that judges consider that autopsy findings may be hampered by the organ removal because of the required surgical procedures.…”

Impacts of Forensic Outcomes on Cadaveric Organ Donations in Malaysia

“…Again, the conflict of procuring organs for cadaveric organ donations collides with criminal investigations, which needed efforts both from scientific and procedural rigour as well as the judicial policy of zero refusals to harmonize the two conflicting needs). 27 An interesting report emerged from Spain where excellent coordination between a forensic institute, local judicial system, and local tissue bank has demonstrated that seamless interaction between related agencies can provide a win-win situation in the battle of requiring forensic outcomes versus making full use of cadaveric organ donations. Albeit the donated organ, in this case, is mainly the cornea, it still offers hope and directional policy to cater to both needs.…”