Wide Disparity in Organ Procurement Procedures
The nation's 61 organ procurement organizations differ "wide[ly]" in deciding whether to remove an organ from a deceased person for transplant, a new National Institutes of Health study has found. Conducted by Dave Wendler and Neal Dickert of NIH's Department of Clinical Bioethics, the survey found that just 29 OPOs, the private organizations responsible for procuring organs from cadavers, have "an official policy on whether to follow the wishes of the deceased or of family members," the AP/Contra Costa Times reports. Here are some further findings of the study, published in today's Journal of the American Medical Association:
- Only seven OPOs (12%) said they "would probably" remove the organ of a person who had indicated this preference on a living will or donor card but whose "survivors opposed it."
- Fifty-two groups (85%) said they "rarely have documentation of the deceased's wishes." When documentation exists, 51 groups (84%) said "families do not always go along with the deceased's wishes" (Tanner, AP/Contra Costa Times, 1/16).
- When asked whose wishes were given priority in "determining consent," 19 groups said the deceased, 19 said the next of kin, 13 said "they only procure organs if neither party objects, while eight said they go ahead with procurement if neither party consents or neither objects." Two said they didn't adhere to any of these policies.
- Fifty groups (82%) said they would use a national computer registry that lists the intentions of donors.
These discrepancies, the authors said, "appear to be traceable to implicit ethical disagreements about whose wishes should be followed" in organ procurement, and not due to "legal or publicity concerns as has been widely reported" (Bowman, Scripps Howard/Pittsburgh Post-Gazette, 1/17). While all states have laws giving preference to the wishes of the donor, "laws generally give wide latitude to procurement groups," Susan Gunderson, president of the Association of Organ Procurement Organizations, said (AP/Contra Costa Times, 1/16). Scripps Howard/Pittsburgh Post-Gazette reports that this "jumble of approaches" may contribute to the shortage of donations that currently exists in the United States. In 1999, the year in which the survey was conducted, 6,448 people died while waiting for an organ transplant (Scripps Howard/Pittsburgh Post-Gazette, 1/17). "Most people agree" that the best way to solve this problem is to "increase donation," according to the AP/Contra Costa Times. Writing in an editorial accompanying the study in today's JAMA, University of Southern California ethicist Alexander Capron said "the survey bolsters suggestions that weaknesses in the procurement process have contributed to the shortage" (AP/Contra Costa Times, 1/16). To read the full report, go to http://jama.ama-assn.org/issues/current/rfull/jsc00286.html.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.