Organ Donation Organization Unethical

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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.

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

I agree with you OP. If it was my family member and I'd already said no, I better not see or hear anything else about it. Leave alone in peace to grieve.

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Specializes in Nephrology, Cardiology, ER, ICU.

Great topic for debate but just a friendly reminder to please debate the topic, not the poster. Thanks.

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I agree with you OP. If it was my family member and I'd already said no I better not see or hear anything else about it. Leave alone in peace to grieve.[/quote']

you beat me to it! i am pro donation, but once "no' has been said, that is the end. another approach may result in some physical contact that the rep may not welcome.

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Asking three times is just wrong. I am an organ donor, believe in organ donation, have watched organs being harvested. But .... if a family says no, then it is no! To keep coming back, or sending in another more knowledgeable team member to try to get them to change their mind after repeatedly say no, is just wrong. I have had family members be the recipient of organ donation so I understand the need. But the needs of the donating family don't just get shoved to the bottom of the pile. Finally, if a party was thrown for the floor for delivering six sets of organs in one month really happened, then that is downright disgusting. It was disgusting to even type that last sentence thinking it happens.

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Specializes in PDN; Burn; Phone triage.

I never said my argument wasn't intelligent. People were passively questioning my intelligence throughout the thread. i.e. But surely you know that if you've been an ICU nurse for six years?" and "You were misinformed."

No, I'm sorry that my comment was misinterpreted. I literally meant "I think I am stating something that you know but I could be wrong." It wasn't meant to be passive.

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I understand that the process does seem barbaric. When I was a floor nurse, we called the organ procurement agency and had to notify them. Every time I interacted with anyone from the OPA on our unit they were great and they didn't push a million buttons to get the family to agree if they didn't want to. It's been my experience from the dealings I've had with the OPA here that I could make the same assumption. I suppose though, it may not be that way everywhere or that some people may not be as "wonderful". I mean there are people who are really good at things and others who are less good at the same things. I guess my question is - is the issue specific people from the agency or is it the agency overall? If it's employees/representatives then that is one thing, if it's the entire organization/everyone then in my opinion that's a bigger problem. Not that the people shouldn't be dealt with...

I don't know. Often times there isn't time to waste. Sometimes you have a stable brain dead patient and things can slow down some. Sometimes you have patients who don't meet brain death requirements - our state allows donation after cardiac death (which is a whole other ball of wax).

I understand having to call, and making it a conversation that someone else is leading. It was explained to me (perhaps erroneously) that the rationale for the OPA representative leading the conversation (unless family brought it up first) was because then it doesn't appear like the healthcare team is pushing them towards it.

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This is not about if organ donation is right or wrong, it's about the certain practices...

I add that caveat only as info that I'm not commenting about your post because I'm against organ donation. I've been here a long time and sometimes posts can be misinterpreted. :)

Asking three times is just wrong. I am an organ donor, believe in organ donation, have watched organs being harvested. But .... if a family says no, then it is no! To keep coming back, or sending in another more knowledgeable team member to try to get them to change their mind after repeatedly say no, is just wrong. I have had family members be the recipient of organ donation so I understand the need. But the needs of the donating family don't just get shoved to the bottom of the pile. Finally, if a party was thrown for the floor for delivering six sets of organs in one month really happened, then that is downright disgusting. It was disgusting to even type that last sentence thinking it happens.

We have a hopsice IDT today and are going to discuss this. The rep from the donor network told me that IF I had advanced directives with the box checked AGAINST being an organ donor, then all would be well. But the advanced directives did not have that box checked so they were going to call the legal rep of family even though the family said no. I think we'd like to start addressing this fairly soon after admit to hospice with our patients and family members. So we have a firm yes or no decided way ahead of time.

I understand having to call, and making it a conversation that someone else is leading. It was explained to me (perhaps erroneously) that the rationale for the OPA representative leading the conversation (unless family brought it up first) was because then it doesn't appear like the healthcare team is pushing them towards it.

It was explained to me by the donor network rep I was talking to at 0145 a.m. a few nights ago that they started training people specifically to deal with families of dying or dead patients regarding encouraging donation. And that I was not supposed to tell the family that there would be someone calling in an hour. And I was not supposed to talk about donation to the family because I didn't have that "special" training. Sounded like subterfuge to me.

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Many people never make a decision one way or the other on organ donation because we all feel "invincible" in life. That one brain dead patient, if the family consents, could save the lives of at least 8 people who are waiting on the transplant lists. I don't see anything unethical about talking to the family about organ donation when the patient has been declared brain dead.

You say it's unethical for a someone to sales pitch the family on organ donation when their wishes have been made clear. That statement is an outright lie. First of all, if the family says "no", that's the end of the discussion. Secondly, they're not being sales pitched. The family isn't buying anything and neither is the organ donation group; they are simply trying to get perfectly usable organs from a brain dead person to 8 people who will also die if they don't get them.

What would be unethical is if no one bothered to ask and 8 people died. Most people don't understand the ins and outs of organ donation and that's why it really requires someone coming out, in person, to explain the process. As an ICU nurse, you should know this. If not, have an organ donation specialist explain it to you so you know what you're talking about.

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Specializes in Oncology; medical specialty website.
Wow, the timing of this thread is shocking!

I'm in California as well and I work hospice. For our hospice patients in SNF, when they die, we have to call that 1-800 number. I've been doing it for years but recently it has gotten more difficult to deal with them. Even if you say the family has said no, they continue to ask you questions that take about 20 minutes to ascertain if the patient would be a candidate.

I had a patient die a couple of days ago. Uterine cancer with mets everywhere. She had a large open necrotic coccyx wound. When she died, I called her family and then started the paperwork as I called the Donor Network. I told the rep the family said no and again, had to answer all the questions. Very detailed, H&P, labs, X-rays, MRI, CT scans, etc.

The rep said the patient qualified for skin donation. I told her the family had already said no to donation - the legal rep of the family. I was told that another specially trained person would be calling back in an hour to talk with the family about donation and I should not talk to the family about the upcoming phone call or anything about donation.

I was appalled. So, OP . . . I totally get your point.

And I am in favor of donation.

But this new way to change people's minds reminds me of Mortuaries and how they prey on the grieving families in order to get them to purchase more expensive caskets.

"Predatory" and "unethical" indeed.

I'm still fuming about it . . . :mad:

That is disgusting. They sound like vultures, trying to scavenge any last scrap from a body. And I'm with you...I don't like the idea of browbeating grief-stricken families.

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You say it's unethical for a someone to sales pitch the family on organ donation when their wishes have been made clear. That statement is an outright lie. First of all, if the family says "no", that's the end of the discussion.

I going to repeat it again. This is not about if organ donation is right or wrong, this is about certain practices. I'm not the only one that's experienced this OP. So, no, it's not a lie. Just because you've never experienced it, doesn't mean it doesn't happen.

Great topic for debate but just a friendly reminder to please debate the topic, not the poster. Thanks.
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...You say it's unethical for a someone to sales pitch the family on organ donation when their wishes have been made clear. That statement is an outright lie. First of all, if the family says "no", that's the end of the discussion. Secondly, they're not being sales pitched. The family isn't buying anything and neither is the organ donation group; they are simply trying to get perfectly usable organs from a brain dead person to 8 people who will also die if they don't get them.

What would be unethical is if no one bothered to ask and 8 people died. Most people don't understand the ins and outs of organ donation and that's why it really requires someone coming out, in person, to explain the process. As an ICU nurse, you should know this. If not, have an organ donation specialist explain it to you so you know what you're talking about.

The family said no in my experience a few days ago.

Again, this is NOT about organ donation. I'm fully in favor of 8 other people getting a chance to live or have better health due to organ donation.

Some of us are talking about the instances where the donor network reps give us that hinky feeling of taking advantage of people in grief.

I work in hospice. Our patients who die at home can make decisions to donate or not but we are not required to call the donor network when they die.

Our patients who are in SNF and die, we are required to call.

We need to address this before the death and will work on that today in our meeting.

(Pro-donation member here who also donates blood, plasma, and will soon be on the bone marrow donation list).

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Specializes in Adult MICU/SICU.

I feel ya on this one. It seems wrong on so many levels my skin crawls. This seems like a big job for one nurse - what are your coworkers thoughts?

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