Most organ procurement organizations (OPOs) rely on family consent to procure a patient's organs, even if the patient has signed a donor card, according to results of a survey recently released by the United Network for Organ Sharing.
The Advance Directives and Donor Card Effectiveness Survey was conducted to examine the feasibility and legal ramifications of enforcing the wishes of deceased persons who have signed organ donor cards or other forms of advance directives. "Survey results confirm an ambivalence among the OPO community toward the usage of advance directives," UNOS reported in a summary written by Donna Henry Wright, JD. A total of 43 of the nation's 63 OPOs responded to the survey.
The survey found that 84% of responding OPOs would only take a patient's organs after obtaining family approval, 70% did not know whether potential donors had directives, and up to 60% rarely check for advance directives.
The results indicate "a deep division within the OPO community between deference to the patient's rights and to family rights and concerns," Wright wrote. UNOS identified three strategies to address the balance between honoring the wishes of the deceased patient and those of surviving family members:
Referral of all hospital deaths to OPOs. Currently, only 21% of OPOs have more than half of their hospitals reporting all deaths, UNOS said.
24-hour access to a registry or database of intent to donate. UNOS said that families should be informed of the donor's registered desire to donate because "99% of families give consent in agreement with their loved one's predetermined choice."
Policy of informing families of a decedent's wishes rather than asking for consent. Most family members "are relieved to know and fulfill their loved one's intentions," UNOS said.
A report that includes an appendix describing laws regarding organ and tissue donation and an appendix describing the survey results is posted at www.unos.org/Newsroom/archive_survey_coadonorcard.htm.
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