Do not Talk to Families about Organ Donation
Matthew J. Weiss MD
Solid-organ transplantation is the therapy of choice for patients with end-organ failure. Despite numerous advances in the field, the number of individuals awaiting transplantation continues to exceed the supply of organs. One approach to increasing the supply of organs is to maximize donation rates of eligible patients. Family consent rates for donation are currently only 30% to 40%. Although families decline donation for many reasons, it is indisputable that there are myths believed to be true by families that do not aid in increasing the donation rate: patients will be prematurely declared dead to “get better organs,” the organ allocation system is corrupt, and rich people “get the good organs.” Particularly damaging is the perception that the physician caring for a loved one may have allegiance to a future organ recipient. This can compromise the trust necessary for increasing donation rates. Therefore, it is important that physicians caring for the potential donor do not discuss donation with the family. During the last hours of life, the physician caring for the potential donor must continue to provide aggressive care. The donor family must understand and believe that everything has been done for their loved one.