By Don Colburn 1995, The Washington Post
St Louis Post-Dispatch (MO)
FACING an increasingly dire shortage of organs, transplant teams have long assumed that organ donation would rise if doctors would just approach more families and broach the subject at the trying time of a relative's death. New findings suggest it's going to be much more complicated.
A large study of potential organ donor cases in Pittsburgh and Minneapolis shows that the biggest obstacle to organ procurement is the low rate of consent among families.
"It's not simply a matter of getting health-care providers to ask the question," said Laura A. Siminoff, director of research projects at the University of Pittsburgh's Center for Medical Ethics, who led the study. "That was wishful thinking. A lot of people just say no."
The study debunks two key assumptions of recent public policy on organ donation: that most families will donate if asked, and that most health-care teams don't ask.
The Pittsburgh-Minneapolis study found that families were approached about organ donation in 87 percent of eligible cases. Fewer than half of those - 48 percent - agreed to donate kidneys, livers, hearts or other transplantable organs. A lower percentage of families agreed to donate skin, bones or other bodily tissues (35 percent) or corneas (23 percent) for transplantation.
Siminoff's team reviewed the medical charts of more than 10,000 deaths during a 20-month period at 23 hospitals in the Pittsburgh and Minneapolis-St. Paul metropolitan areas. About one out of six patients who died was eligible to donate some combination of organs, tissues and corneas. Researchers interviewed the doctors, nurses, social workers and clergy who spoke to families in 827 of those cases.
"Although health-care professionals do request that families donate, families consent to donation less frequently than was previously assumed," concluded the study, published last month in the Annals of Internal Medicine. …