151. Public policy governing organ and tissue procurement in the United States: results from the National Organ and Tissue Procurement Study
- Author
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Siminoff, Laura A., Arnold, Robert M., Caplan, Arthur L., Virnig, Beth A., and Seltzer, Deborah L.
- Subjects
Donation of organs, tissues, etc. -- Ethical aspects ,Organ donors -- Laws, regulations and rules ,Health - Abstract
* Objective: To determine why Required Request policies, which mandate that hospitals request donation from donor-eligible families, have not resulted in increased organ procurement. * Setting: Stratified sample of 23 acute-care general hospitals in two metropolitan areas. * Design: Chart review identified all eligible donors in study hospitals during a 20-month period. Health care professionals who spoke with the families of eligible donors after death were interviewed to determine families' and health care providers' behaviors after patients' deaths with reference to the donation process. * Participants: All patient deaths (n = 10 681) were reviewed, and 841 donor-eligible cases were chosen for in-depth study; 1809 health care professionals who provided care to these patients were interviewed. * Measurements: The ability of health care providers to identify donor-eligible patients, approach families about donation, and obtain families' consent to donation. * Results: 83% of health care professionals correctly identified donor-eligible patients. The families of donor-eligible patients were approached about donation in 73.0% of the cases. Families were more likely to be approached about organ (86.6%) donation than either tissue (69.5%) or cornea (67.3%) donation (P < 0.001). The families of organ-eligible patients were less likely to be approached if the patient was female, was on a general medical or surgical floor, or was being cared for by internists. Only 46.5% of families of eligible donors agreed to donate organs, 34.5% agreed to donate tissues, and 23.5% agreed to donate corneas. * Conclusions: Although health care professionals do request that families donate, families consent to donation less frequently than was previously assumed. Empirically based education campaigns are needed so that health care professionals can improve their communication skills and so that discussion about this important issue can be stimulated among family members., Improved public health education may increase the low rate of organ and tissue donation. Legislation mandates that hospital staff inquire about the willingness to donate. Analysts interviewed 1,809 health care professionals in 23 acute-care hospitals with respect to their practice of requesting donations. Based on 841 eligible patient deaths, health care providers correctly identified more than 80 percent of eligible donors after the fact. Health care team members approached 86.6% of the families regarding organ donations. Families of patients who were younger, female, and received care in a medical or surgical ward received fewer donation requests. Tissue and cornea donation requests happened much less frequently, in about two-thirds of all eligible cases. Only 79 of 170 approached families agreed to donate organs. The overall willingness to donate was about 34%. More educational efforts need to address the reluctance of families to donate organs and tissues of their deceased.
- Published
- 1995