title: Addressing Consent Issues in Donation After Circulatory Determination of Death.
abstract: Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients.
authors.affiliation: a Weill Cornell Medical College.
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Overby
authors.forename: Michael S
authors.initials: MS
authors.lastname: Weinstein
authors.forename: Autumn
authors.initials: A
authors.lastname: Fiester
mesh_terms: D000328:Adult; D001775:Blood Circulation; D001926:Brain Death; D002319:Cardiovascular System; D002648:Child; D003643:Death; D003657:Decision Making; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D016743:Mental Competency; D033282:Parental Consent / Q000941:ethics; D011639:Public Opinion; D012945:Social Values; D020458:Third-Party Consent / Q000941:ethics; D014019:Tissue Donors; D014022:Tissue Survival; D020858:Tissue and Organ Harvesting / Q000941:ethics*; D009927:Tissue and Organ Procurement / Q000941:ethics*; D035502:Trust
keywords: chronic conditions; disability; end-of-life issues; informed consent; organ transplantation; rehabilitation