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Mandatory reporting of "imminent" death to identify organ donors: history, controversy, and potential solutions

[Déclaration obligatoire de mort "imminente" pour identifier des donneurs d’organes : histoire, controverse et solutions possibles]

From the Program of Critical Care Medicine and Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital and University of British Columbia, Vancouver, British Columbia, Canada.

Address correspondence to: Dr. Peter Dodek, Intensive Care Unit, St. Paul’s Hospital, Centre for Health Evaluation and Outcome Sciences, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada. Phone: 604-806-9023; Fax: 604-806-8674; E-mail: pedodek{at}interchange.ubc.ca

Purpose: To review the history of mandatory reporting for the purpose of identifying potential organ and tissue donors, and the controversy around the terms, "imminent" or "impending" death, and to suggest a solution to this controversy.

Source: In this narrative review, published papers were retrieved based on a Medline search using the terms, "mandatory reporting" and "organ donation." In addition, unpublished data from the United Network for Organ Sharing and the Pennsylvania Gift of Life Program were reviewed.

Principal findings: There has been no demonstrable effect of mandatory reporting of "imminent" death independent of educational activities on numbers of organ donors or organs transplanted. Furthermore, mandatory reporting of "imminent" death does not meet criteria of an acceptable screening test.

Conclusion: Education of health care providers about eligibility for organ and tissue donation and about whom to report as a potential donor will hopefully lead to identification of more individuals who meet criteria for organ donation and who will go on to donate organs to the many potential recipients.

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