[dr z]

A man arrives at the emergency department on a ventilator after an accident, He is brain dead by all criteria. He has an organ-donor card in his wallet indicating his desire to donate. The organ-donor team contacts the family. The family refuses to sign consent form for the donation.
What should be done?​

a. Remove the organs any way.
b. Wait for the patient's heart to stop and then remove the organs.
c- Stop the ventilator and remove the organs.
d- Seek a court order to overrule the family.
e- Honor the wishes of the family; no donation of the organs.

plz help me with an answer. :toosad:
​

 

[docnas]

according to Fischer's book the family comes first in this case if they say no organ donation then no donation even if he has it written that he wants to be a donor.

 

[dr z]

do u agree!

yes u r absolutely right this is one of is 100 cases book , but do u agree with the answer, according to kaplan book patient wishes r first and when we dont know patients wishes then v can ask his family. these two seem to contradict with eachother :notsure:

 

[Mondoshawan]

e. honor the family's wishes

I agree with docnas. The donor card is more for the family than for the hospital. Once the patient is dead, his body is the legal property of his family, and it is they who have the final say. The only exception to this would be either a very explicit will (which can still be problematic) or if the patient had died in a state with first-person consent laws (meaning the family cannot override the advance directive of organ and tissue donation). However, the family's permission would not have been sought in either of these case, and these scenarios are too complicated for the boards. I think the key to this question is docnas' rule about the family always having precedence in organ donation and the fact that permission was sought in the first place.

 

[docnas]

Actually i had the same thought myself that his wishes should come first since he decided to be an organ donor and has it in writing according to the concept of autonomy family approval should not be an issue. Atleast that is how i saw it but again book says different so ....

 

[docnas]

I agree with docnas. The donor card is more for the family than for the hospital. Once the patient is dead, his body is the legal property of his family, and it is they who have the final say. The only exception to this would be either a very explicit will (which can still be problematic) or if the patient had died in a state with first-person consent laws (meaning the family cannot override the advance directive of organ and tissue donation). However, the family's permission would not have been sought in either of these case, and these scenarios are too complicated for the boards. I think the key to this question is docnas' rule about the family always having precedence in organ donation and the fact that permission was sought in the first place.

I just read up on First person consent laws and i see that donor cards are not legally binding unless that state has passed the first person consent law. So that clears it up on how his directives can be overruled. And also once i read the booklet and came across the question after reading the answer that was how i rationlized it ie body once dead belongs to the living and they have autonomy over it.

 

[dr z]

.....ok

Thanks friends , now this explanation makes sense to me :happy: