The physician's role in discussing organ donation with families.

Full Abstract

Federal Conditions of Participation from the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) introduced in 1998 require that all families be presented the option of organ and tissue donation when death is imminent. The perception that physicians were being excluded from participating in this process led to a resolution at the American Medical Association House of Delegates meeting in December 1999, calling on the American Medical Association Council on Scientific Affairs to review the Conditions of Participation "to ensure that there is no prohibition of physician involvement in the organ donation process..." The number of organs procured for transplantation in the United States is insufficient to meet needs. Families' hospital experiences significantly affect their decisions to donate organs. Discussing severe brain injury, brain death, and organ donation after brain death with families is a specialized form of end-of-life decision-making and care in the intensive care unit; however, the knowledge, skills, and attitudes necessary for physicians and nurses to promote good end-of-life decision-making are widely variable. The federal Conditions of Participation require that those making requests of families for organ donation receive specific training. They do not prohibit physician involvement in initiating organ donation requests, provided these individuals are properly trained. Physicians have an important role in caring for patients and families in these circumstances, and the care they provide is enhanced through training, attention to the special issues involved, and collaboration with organ procurement organization personnel.

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Author information

Author/s: Williams, Michael A (MA); Lipsett, Pamela A (PA); Rushton, Cynda H (CH); Grochowski, Eugene C (EC); Berkowitz, Ivor D (ID); Mann, Stephen L (SL); Shatzer, John H (JH); Short, M Priscilla (MP); Genel, Myron (M); Council on Scientific Affairs, American Medical Association;

Affiliation: Johns Hopkins Medical Institutions, Department of Neurology, Johns Hopkins University Bioethics Institute, Baltimore, MD, USA.

Grants: 1 H39 0T00004.01 (Agency:PHS HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, U.S. Gov't, P.H.S.; Review

Journal: Critical care medicine (Crit Care Med), published in United States. (Language: eng)

Reference: 2003-May; vol 31 (issue 5) : pp 1568-73

Dates: Created 2003/05/28; Completed 2003/06/16; Revised 2007/11/15;

PMID: 12771634, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Crit Care Med. 2003 May;31(5):1595-6. (PMID: 12771648)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Attitude to Death
Centers for Medicare and Medicaid Services (U.S.)
Communication
Critical Care - ethics; legislation & jurisprudence; methods
Decision Making
Family - psychology

Health Knowledge, Attitudes, Practice
Humans
Physician's Role
Professional-Family Relations
Tissue and Organ Procurement - ethics; legislation & jurisprudence; methods
United States

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