Organ donation in the forensic setting

Abstract

In 2018, over 1,782 Australian’s lives were transformed by organ and tissue donation. Although Australia generally performs well in this area the aim is to further improve organ and tissue donation rates, and these rates vary between states. However, there are numerous barriers to successful organ donation. Many of the cases in which organ and/or tissue donation is requested fall within the Coronial jurisdiction / forensic medicine setting. In this setting the final decision regarding consent, and/or restriction of organ and tissue donation lies with Coroner who is advised by the forensic pathologist. However, within New South Wales there are no objective guidelines for forensic pathologists and Coroners to follow, and consequently subjective decisions are made which are reliant on experience and personal preference in a time critical and challenging setting. Ultimately, maintaining the principles of autonomy, justice, beneficence, and non-maleficence while trying to optimise organ donation is not an easy task. This presentation provides a review of the Coronial cases within New South Wales Health Pathology Forensic Medicine (Sydney and Newcastle sites) in which organ donation was requested in 2018 and 2019, and highlights Coronial consent issues in certain cases. Furthermore, objective guidelines are proposed to facilitate consistency and streamline the decision-making process in future cases.