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White Paper: Ethical Considerations of Imminent Death Donation

This new white paper provides an ethical analysis of Imminent Death Donation (IDD), focusing on potential organ donors who do not meet brain death criteria or are not DCD candidates. The resource explores IDD in cases of irreversible neurologic injury or patients dependent on life support who choose not to continue life support. The Ethics Committee discusses the ethical implications, benefits, and risks associated with IDD, ultimately recommending against its pursuit at present due to potential risks and lack of support.

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White Paper: Ethical Considerations of Imminent Death Donation

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  1. White Paper:Ethical Considerations of Imminent Death Donation Ethics Committee

  2. What is this resource? • New white paper from the Ethics Committee • Provides an ethical analysis of imminent death donation (IDD) • Target audience: • Transplant hospitals or OPOs counseling families or surrogates of potential donors • Specifically those who want an option for donation when the potential donor does not meet brain death criteria and is not a DCD candidate

  3. What is Imminent Death Donation (IDD)? IDD is a term that has been used for organ recovery from a live donor before withdrawal of ventilator support expected to result in the patient’s death. IDD applies to at least 2 types of potential donors: • An individual with devastating neurologic injury that is considered irreversible and who is not brain dead. • A patient who has capacity for medical-decision making, is dependent on life-support, has decided not to accept further life support who wants to donate

  4. Background and Results of Ethical Analysis The Committee analyzed if IDD, compared to existing practices of attempting donation after cardiac death (DCD) could: • Honor the preferences of the potential • Support the preferences of the potential donor’s family or surrogate • Increase the number of potential organ donors • Increase the quality of organs donated for transplantation

  5. Background and Results of Ethical Analysis The Committee determined: • IDD may be ethically appropriate and justified by the potential benefits to donors, donor families and recipients • Lack of data makes it impossible to conclude if IDD would increase the number of organs available for transplant • IDD has the potential to erode public trust in organ donation

  6. Final Recommendations • The OPTN should not pursue IDD (at this time) due to its potential risks, the lack of community support and substantial challenges to implementation. • In the future, it may be possible to adequately address those challenges through additional research, careful policy development or revision.

  7. How will members access this resource? • Members will be able to access this resource through the OPTN website • Current white papers are available under the Resources tab, select Ethics

  8. Questions? Peter Reese, M.D. Committee Chair peter.reese@uphs.upenn.edu Lee Bolton Committee Liaison lee.bolton@unos.org

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