Paola Nicolas will present a talk at the upcoming International Conference on Clinical Ethics and Consultation on
Friday, May 31 in Montreal:

Paola Nicolas

What Exactly Is The Medical Ethicist’s Role When Family Members Refuse Organ Donation after Brain Death Determination?

In accordance with the Uniform Anatomical Gift Act and the laws of New York State, Medical Staff members are prohibited from approaching the patient’s next-of-kin to obtain consent for organ/tissue donation. Only the Organ Donor Network representatives may approach the patient’s next-of-kin for consent to organ/tissue donation. This paper will discuss the case of a brain dead 33-year-old patient, after a re-rupture of aneurysm, who appears to be an organ donor per his driver license, but his family argues that the deceased had recently changed his mind and explicitly expressed his desire to be buried “intact”. What is the clinical ethicist’s role in those situations? Whereas the Revised Uniform Anatomical Gift Act explicitly reaffirms that if a donor has a document of gift, there is no reason to seek consent from the donor’s family, how do we approach situation where family members argues that patient’s wishes have changed? This paper will evaluate the legal implications of considering clinical ethicists as medical staff members in case where the family objects to organ donation and refuses organ retrieval from the deceased by organ procurement agency. This paper will propose strategies for clinical ethicists to address those legal and ethical concerns and ways to be advocates for family members while being compliant with local hospital policies and state laws.

Objectives

  1. Assess the legal obligations set by the Uniform Anatomical Gift Act and the laws of NYS as well as institutional policies regarding organ donation conversations
  2. Evaluate the competing obligations between honoring the dead interests and the needs of the living
  3. Propose strategies for clinical ethicists to be advocates while being compliant with local hospital policies and state laws.