When are bereaved family members approached for consent to organ donation: Commentary from 10 European member states

Abstract

Background - To scope the timing of the approach to bereaved family members and request for organ donation in DBD and DCD potential donors, in 10 European member states. Are there changes in established practice regarding when family members are asked to consider organ donation? Methods – Representatives from 10 member states responded to a survey seeking information about: how death is diagnosed in the DBD and DCD potential donor; the legal consent system and law on organ donation; the existence of national or local protocols specifying when to approach relatives; and practices around the first moment of discussing organ donation and the formal request. Results – Findings suggest that the historic practice of decoupling the confirmation of death discussion and the request for organ donation in the potential DBD situation is becoming more ‘flexible’ or is changing to one in which a discussion about the potential of organ donation is taking place before confirmation of death. Conclusions – Decisions about the moment of asking may benefit from being embedded within local practices of ‘end of life’ care. Establishing donation as a usual part of end of life care would mean that the moment of asking would become a step in the dying trajectory, facilitating the fulfilment of wishes regarding post-death use of organs for transplantation.