Organ Donation Organization Unethical

[dangerous1]

I've been a critical care nurse for 6 years, I'm employed at a Southern California hospital that mandates all nurses taking care of poor prognosis patients to report them to one organ donation company. If a nurse fails to comply or report it to that "none profit" organization, even if the family does not want to donate organs, we are written up. Essentially, we are forced to call them regardless and this organization sends a nurse to persuade the next of kin in their vulnerable state. I mean within hours of being declared brain dead.

If the deceased did not make their wishes known about organ donation, nurses should not force another third party to come in and try to sales pitch them. I asked one of the family's what they said, and they said all the good things that come from it, i.e. a tragedy. I think the organ donation organization plays on their vulnerability.

I've done research on this particular organ donation company and the CEO makes well above $500,000. I've seen invoices from other hospitals the amount of money that goes into harvesting an organ and clearly have been disenchanted by the thought of donation. Additionally, this organization threw a thank you party for our unit because we had 6 organ "harvesting" in a month.

I feel there are HIPAA violations of reporting something to a third party without the family's knowledge and mandating it by the hospital. Note, we do not get permission from the family to divulging information about the decease.

[dangerous1]

@ Rose_Queen, MSN, RN

I know it's my opinion, that's why I stated "I think" many times throughout my post. But, clearly, you felt the need to one, concentrate on my mention of the CEO's salary and provide me the job description of the "third party."

I can appreciate you ignoring my opinion "Bringing in a third party after the family already made their wishes known regarding organ donation and during the grieving process seems predatory and unethical."

I wasn't asking how, I was really looking for an intelligent response like the first poster wrote.

[KatieMI, BSN, MSN, RN]

From the one who was in transplant trenches for a while:

"Donation" of organ/tissues is much more involving and multi-faceted process than most of health care professionals know of. When people mark that square on driver's license, they think about heart, lungs and livers. But only the minority of patients can be solid organs'donors for many reasons. I am not sure if the "third party" you are concerned with is Gift of Life, as I am familiar with only this organization. But professionals working with Gift of Life speak about much more than solid organs donations. There is, for example, permanent shortage of bone material (basically, powdered long bones) used as cement for bone and joint surgeries. There is, also, shortage of pathology material. The US research in molecular genetics of melanoma, for one cause, is stalling because of not enough tumors are donated. Due to the absense of ridiculous regulations, leading research in this area is now performed in Taiwan, where massive amount of surgeries are performed within "medical tourism" industry yet all removed matetial can be used for research without anyone's permission.

If you aware of the fact, the main discovery done as a result of "Ice Bucket Challenge" campain was recognition of the NEC gene point mutations as being probably the main culpit in development of ALS. That was possible simply because of 15000 patients donating their materials postmortem (and we're speaking about whole cadavers, as nobody knew where exactly to look for the material - central or peripheral nervous system). Thanks for some brave people who donated their brains we know now more about posttraumatic brain injury. Same story now happens with primary pulmonary hypertension, liver steatosis, pancreatic cancer and CLL. All these diseases' research requires tissues donations to continue, and a lot of them.

Unfortunately, we nurses who work with these families 1) do not have enough knowledge of the process; 2) do not have time to teach them it all; and, the worst 3) may very well look like interested party. I'd heard that urban legend that "they do not work hard enough so that they could get organs". You know how much truth it holds in reality, but there are plenty if folks who think like that. I think it is actually better if there can be someone else to sit and speak with the family than forever rushed staff nurse who physically feels moments ticking by.

Unfortunately also, the most opposing donations populations are the also ones in greatest needs of them, notably ethnical minorities.This people have to be spoken with. They may not want to hear it all, but it is not about their wishes today and now. It is about others, and their own kids and grandkids.

[dangerous1]

I think, just the persuasiveness and persistence of some of the representatives from these organizations are why I'm questioning the ethics behind it all.

I've had families say no outright upon meeting with representatives and then, after further meetings with them, the family changes their mind. Like, why should there be more meetings when they already said no?

Being coaxed to donate organs bothers me even if it is a utilitarian.

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[BSN16]

I do not EVER talk to a family about donating organs unless they ask me about it. That is the job of the donor network, studies have shown that if a third party comes in and discusses this, rather than a caregiver, they are more likely to say yes.

It's not a sale's pitch...people need these organs!!

[KatieMI, BSN, MSN, RN]

I think, just the persuasiveness and persistence of some of the representatives from these organizations are why I'm questioning the ethics behind it all.

I've had families say no outright upon meeting with representatives and then, after further meetings with them, the family changes their mind. Like, why should there be more meetings when they already said no?

Being coaxed to donate organs bothers me even if it is a utilitarian.

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Well, patients say outright and not so outright "no" every day re. stopping smoking, eating healthier, doing flu shots, taking their meds as they supposed to, etc. Does it mean we should stop teaching them?

[CelticGoddess, BSN, RN]

I think, just the persuasiveness and persistence of some of the representatives from these organizations are why I'm questioning the ethics behind it all.

I've had families say no outright upon meeting with representatives and then, after further meetings with them, the family changes their mind. Like, why should there be more meetings when they already said no?

Being coaxed to donate organs bothers me even if it is a utilitarian.

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When organ donation hits close to home, maybe you'll change your opinion. My mother is on the liver transplant list because of auto-immune hepatitis (I specify that because far to many people think she needs a liver due to alcohol-she doesn't drink or drug abuse-share barely takes aspirin). If a patient with a healthy liver, who matches my mum, were to become eligible to donate, you better believe I would want the family to be notified. I would want them to understand the need.

I am going to lose my mother. And I am not ready for that.

I have already lost a cousin I was very close to because they were unable to procure him a heart before he died (he had polio as a child and his heart was damaged as a result, He was born before mass vaccination)

I think it's actually unethical to ignore the needs of children, young adults and adults who might actually have a good life if they are able to get the transplants they so desperately need. Many people do not understand the need. And that is why the 3rd party is involved in the procurement of organs. They are trained to be sensitive to the needs of ALL parties involved.

[dangerous1]

Well, patients say outright and not so outright "no" every day re. stopping smoking, eating healthier, doing flu shots, taking their meds as they supposed to, etc. Does it mean we should stop teaching them?

Please do not compare donating organs to saying no to smoking, eating healthy, and flu shots.

How are they similar? Are the patient's family vulnerable and grieving while they are asked to not smoke, eat healthy, or flu shots. I'm not against education but, there should a be a limit to how many meetings are to be held.

[dishes, BSN, RN]

It's OK to question the ethical principles behind organ procurement and there are no right or wrong answers in ethics.

[dangerous1]

@CelticGoddess

When organ donation hits close to home, maybe you'll change your opinion.

You're assuming I never encountered organ donation close to home. I'm sorry for your disposition, but, I can see how it would be difficult for you understand how the other family is being treated for those organs.

Do the ends justify the means? Persistently persuade one family to save a lot more. At what point should the grieving family's wishes be respected?

[KatieMI, BSN, MSN, RN]

Please do not compare donating organs to saying no to smoking, eating healthy, and flu shots.

How are they similar? Are the patient's family vulnerable and grieving while they are asked to not smoke, eat healthy, or flu shots. I'm not against education but, there should a be a limit to how many meetings are to be held.

How many meetings this third party organization can hold if the question has to be solved within short hours?

Are families somehow forced to attend them?

The two processes are similar in terms of a big, heavy decision/action has to he taken, and quickly. When there is a patient, for one example, who suffers from intractable hip pain because his joints are destroyed by OA but he is such high surgical risk from smoking, morbid obesity and uncontrolled diabetes that no surgeon would take him, the talks are going even more dramatic than the ones I did with potential donors and their families. Such patients play with their own life, sure, but what about their families who just need grandpa back, not a cause of heavy monthly bills and endless frustrations?

These people have to be told the truth, hard as it is, and as many times as it takes for them to get it. Too much depends on their "yes" or "no".

[NurseGirl525, ASN, RN]

I have not read this whole thread, but I honestly don't think you understand the process of organ donation.

My unit calls our organ network when any patient reaches a certain test threshold. They may fully recover from their injury. Regardless, the donor people follow.

Its not unethical. You as the nurse cannot approach the family about donation. That is up to the donor people. They are not giving a sales pitch. If the person dies a cardiac death, they have 60 minutes to get those organs. That's it. 60 minutes from time of death, until procurement. That's not very long. With a brain death, that can take days until they get that patient in correct homeostasis to get those organs.

OP, I just think you are misinformed. It's not a pitch. It's saving lives. If the family says no, it's no, unless the drivers license says differently. Those people are trained in how to approach families, which is why we as nurses, do not.

If all organs are a go, at the very least, 8 lives are saved. 8. That's a pretty awesome number. I 100% understand when a family says no to it. That's their decision. But watching what happens when they say yes? It's nothing less than incredible. Maybe you should witness the good side of it sometime. That experience will stick with me forever.

The very last thing it is, is a sales pitch.

[NurseGirl525, ASN, RN]

Please do not compare donating organs to saying no to smoking, eating healthy, and flu shots.

How are they similar? Are the patient's family vulnerable and grieving while they are asked to not smoke, eat healthy, or flu shots. I'm not against education but, there should a be a limit to how many meetings are to be held.

What numerous "meetings" are you talking about? Our organ team follows behind the scenes. They don't at all approach until the decision to wean has been made. I'm very confused.