Neobook — clinical reference

Role of treating doctor
Role of transplant coordinator
Religious considerations
Communication tips

Obtaining consent is often difficult in the grieving family and is a highly specialised field best performed by the transplant coordinator when available. Inappropriate choice of words or lack of clarity can be the difference between successful donation & refusal by the family.

Families will cling to any scrap of hope & merely by saying the ventilator is all that is keeping the patient “going” can imply life to a desperate family. To stress again, it is important for the treating clinician to be very clear about the prognosis of the patient (there is none) & to call in the transplant coordinator early so that there can be every chance of obtaining consent from the family.

Role of treating doctor

Identify potential donors
Refer to transplant coordinator early
Record all the contact details of the next of kin in the patients folder
Brain stem death testing
Family discussion - explain the clinical situation clearly & unambiguously to the family & to introduce the transplant coordinator to take the discussion further.

Role of transplant coordinator

Family discussions
Written consent from the next of kin – spouse, parent, brother, sister, child or legal guardian.
When the cause of death is unnatural & therefore requiring a post-mortem - consent is needed from state pathologist.
Consent is also given by the medical superintendent/hospital manager at the hospital where the donor operation is done.

Religious Considerations

Donation of a family members’ organs is a very personal decision & numerous factors come into play such as education, socio-economic status & religious beliefs. There is however no culture or religion on earth that prohibits the principle of giving or of preserving life.

Although transplantation was not initially practised in most Muslim countries, most have now established transplantation programs. It is always better to ask and give a family the option to support transplantation than to make assumptions.

Communication tips

“There is never a good time to ask…”
“There exists a possibility to help other people in this situation…”
“The body is treated with the utmost respect…”
“What would the patient have wanted…”
“We are here to help you through the process regardless of the decision…”