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[quote=Anonymous]
 I had a job for many years where I was in the ICU at a hospital that provided organ AND tissue donation (they are different processes).

I will say that it is a slow process to be considered for donation after brain death. Many examinations and brain
MRI’s. The MRI usually are showing a massive brain bleed covering the entire brain due to whatever head trauma the patient experienced. These results are discussed with family. They can see the MRI images.

The patient must be examined by two neurologists, a minimum of 6 hours apart, to be declared brain dead. The examination is extensive and criteria are specific and numerous, fixed pupils, etc. This is usually after they have been on life support for quite a while and the family is aware that they will not ever survive off life support.

At this point the family considers what is next. If the patient is a designated donor or if the family wants donation to be considered, then a call is made to the organization that does this (yes, it is a for profit one for tissue donation in my state. I know someone who can see because she had received a cornea donation in another state earlier in life. I also know someone who received a cadaver knee tendon through donation and can continue to walk. Her orthopedic surgeon had access to the tissue bank for the replacement tendon.). Organ donation is a separate org and a nonprofit in my state.

There is then an extensive review of the medical record for organ donation. MOST people are ruled out for organ donation ar this point even if they had been a designated donor on their drivers license and the family wants them to be able to donate. Most organs will not be approved for donation most of the time. The criteria for organ donation are so strict.

As part of the evaluation, a close family member and/or next of kin who knew the patient well must answer a battery of questions and this takes about 20-30 minutes. These are related to the patients health and lifestyle, drug and alcohol use, and other questions as well.

It is required for the next of kin to answer these questions about the deceased if donation is to happen. if the family member declines to do this interview, the donation will NOT go any further even if the patient has designated being a donor on their drivers license and in the state registry.

The drivers license designation IS the patient’s consent to be evaluated for donation, but the family that does not provide the additional info can stop that process. The hospital where I worked did not allow any donation to proceed without the consent of the family at the bedside, the POA, the next of kin.

My experience is that many families in this situation  are disappointed, as well, to find out that organ donation cannot take place due to medical reasons, or the age of the patient etc. (There are age limits). They wanted something good to happen; they wanted their son’s heart to beat on within someone else if he was dead and not coming back.

Regarding full body donation to a science lab, this paperwork needs to be filled out in advance of the patient getting ill and it is a specific form. Get the form ahead of time and fill it out and give it to your loved ones and your doctor to scan into your record, if you want to do this. Your first person consent is required.

If you have a certain funeral home you plan to use, give them a copy as well. The full body donation cadaver will first be transferred to a funeral home for an initial short embalming procedure and then taken to the science institution for storage.

Call the local university or medical school and ask about their process if this interests you. In general, the patient cannot be overweight (150 pounds was the weight limit for our local medical school). Also the receiving institution may not actually need and want the body at the time of death. They may already have all the cadavers they need or can store at the time. So the donation may not continue for that reason as well. This is usually a disappointment to the family as they knew this was something their loved one wanted to do.

My suggestion is to have a conversation with your loved ones about ALL of this and be specific about your wishes but give them full freedom to make whatever decisions they need to make in real time at the time of your death.

What I have done is to not have my donation wishes on a registry and to not have it on my drivers license. My family knows I am glad to donate if it can work out. BUT I am not giving my automatic consent to be considered for donation. I want my three adult children and my spouse to make that decision based on the circumstances at the time of death. They can proceed with donation or not proceed. They can answer the questions about me in the interview or not. If the donation seems to be managed poorly or there is something making them hesitate and not go forward, they can just stop life support and allow my natural death to happen at that point and not proceed with a donation process. I don’t want anything additional about my death to cause compounded trauma for them. If this means I don’t donate, so be it. They will be in charge of what happens. [/quote]

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