Organ Donation: Family Members NOT Honoring Patient Wishes

Abstract

Each year, many organ donation opportunities are missed because of the lack of familial consent. Occasionally, patients' consents for organ donation through the Department of Motor Vehicles (DMV) are posthumously overruled by their families. We assessed the number of potential opportunities for organ donation that are missed because of lack of familial consent despite previously expressed wishes for donation as registered with the state DMV. The medical records of potential donors were reviewed to ascertain appropriateness for donation, familial consent or denial for donation, and number of organs transplanted from each eligible donor. These data were then compared with DMV data regarding prior patient designations either for or against organ donation. One hundred four approaches for donation were made to families during a 3-month period. The DMV donor status was available for 84 patients; 25 were designated as organ donors. Five families refused consent for organ donation despite the patient's documented wishes to donate (80% organ recovery). Twenty-two consents were obtained from the remaining 59 patients not listed as donors by the DMV (37% organ recovery). An average of 3.4 organs were transplanted from eligible donors. DMV designation for organ donation increases the yield of consent for organ donation. However, despite prior DMV designations for donation, 20% of families ultimately denied consent for donation. This translated into 17 missed opportunities for potential transplant recipients during the 3-month study period.