Shifting Responsibilities in Organ Procurement: A Plan for Routine Referral
JAMA. 1988 Aug 12; 260(6): 832-833.
It is claimed that the primary factor affecting the supply of transplantable organs is the cooperation of health professionals. Organ procurement agencies (OPAs) must obtain timely access to potential donors who are mainly identified and contacted by the nurses and neurophysicians in intensive care units (ICUs). The discretion of medical personnel is limited to their judgment about medical suitability for donation while required request laws ensure that the family is offered the option of organ donation. Prottas argues that the hospital and its staff do not have a right to stand between the family and OPAs and that the principle of required request should be implemented through a policy of "routine referral." This policy would require hospitals routinely to inform OPAs of admissions of potential organ donors, thereby increasing OPA access independently of ICU staff behavior. Medical staff would still determine donor suitability and the time when the OPA could contact the family. (KIE abstract)
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