How to Communicate Clearly about Brain Death and First-Person Consent to Donate

Michael is a healthy 21-year-old man who is brought by ambulance to an emergency department after a motor vehicle accident. His family is devastated when he falls into a coma, is put on a ventilator, and, three days later, is declared brain-dead by two physicians. Dr. Allen, the attending trauma physician on service in the intensive care unit that week, explains to Michael's parents the unlikelihood of his recovering and initiates a discussion about whether and for how long the family would like to continue lifesustaining care. Michael's parents are distraught over the idea of stopping it. His mother says, "How can you even suggest discontinuing care? His heart is still beating, he still has life energy inside of him, and you want us to kill him?" Later that afternoon, a nurse taking care of Michael, Rhana, learns that he had registered to be an organ donor on the state's donor registry and lets Dr. Allen know. She asks whether he would like her to inform the local organ bank so it can send an organ procurement representative to speak with the family, as is expected of hospitals when a patient has either died or is in critical condition and is a potential organ donor Rhana and Dr. Allen know that such involvement of organ procurement organizations (OPOs) is standard practice in the US, in order to ensure that all potential donors' families are eventually approached by someone trained to speak to them in a thoughtful manner. However, although OPOs must be notified, organ procurement coordinators may not directly speak with families until death is declared. Although Dr. Allen could follow the regulations strictly and contact the local OPO, he thanks Rhana but says that he will revisit the issue in the next day or so after the family has had more time to process what's happening to Michael

Internet privacy · Computer Science · Grief, Bereavement, and Mental Health · Medicine · Organ Donation and Transplantation · Palliative Care and End-of-Life Issues · Psychology · Social Psychology

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